Utah Name Change Forms – How to Change Your Name in UTUtah Name Change Forms – How to Change Your Name in UT
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Name

Address

City, State, Zip

Phone

Email

I am [ ] Petitioner
[ ] Petitioner’s Attorney (Utah Bar #:__________)

In the District Court of Utah
__________ Judicial District ________________ County
Court Address ______________________________________________________

In the Matter of the Name Change of:

Petition for Name Change

_____________________________________ _______________________________
Petitioner

Case Number

_______________________________
Judge

Petitioner states as follows:
(1)

I live in ____________________________ County, Utah and have lived here for
more than one year.

(2)

The name on my birth certificate is:
First name
Middle name (if any)
Surname

(3)

I ask the court to order that my legal name be (proposed new name):
First name

Petition for Name Change

Approved November 19, 2004
Revised July 26, 2017

Page 1 of 2

Middle name (if any)
Surname on birth certificate
Married surname (if any)

(4)

I want to change my name because:

(5)

I do not know any re