© 2017 Family Law Self-Help Center Consent to Child’s Name Change (Child)
* You are responsible for knowing the law about your case. For more information on the law, this form, and free
classes, visit www.familylawselfhelpcenter.org or the Family Law Self Help Center at 601 N. Pecos Road. To find
an attorney, call the State Bar of Nevada at (702) 382-0504.
CONS
Your Name:
Address:
Telephone:
Email Address:
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
In the Matter of the Application of:
__________________________________
(Parent’s name(s))
For Change of Name of the Minor Children:
__________________________________
(First child’s name)
__________________________________
and (Second child’s name or “N/A”)
CASE NO.: ____________________
DEPT: _____________________
CONSENT TO NAME CHANGE (CHILD 14 OR OLDER)
I, (child’s current name) ___________________________________________________,
am at least 14 years old and consent to have my name changed to (new name)
________________________________________________________. I request that the Petition
for Change of Name be granted.
I declare under penalty of perjury that the foregoing is true and correct.
DATED this (day) ______ day of (month) ______________, 20____.
Submitted By: (child’s signature) ______________________________________
(print child’s name) _____________________________________
