Fill - Free fillable - Family (NJ Judiciary) PDF form

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Family Division

Name Change

- Family

Updated November 1, 2019

How to Ask the Court to Change a Name in the Chancery Division,

Family Part

Superior Court of New Jersey

Who Should Use This Packet?

You can use this packet if you are filing for a name change in the Family Division. The types of

name

changes in the Family Division

are:

• Changing the name of your minor child under the age of 18.

• Changing your name at the same time as requesting a name change of your minor child under

the age of 18.

DO NOT

use this packet:

• If you are an adult changing your name for reasons other than filing for a name change at the

same time you file for your minor child, you should use the Civil Division packet - 10551 -

How

to Ask the Court to Change Your Name - Adults Only.

• If your name change is to resume your maiden name after a divorce, you must file a motion

through your divorce docket. Please note: if your judgment of divorce stipulates that you may

resume your maiden name, you do not need to use this packet and may apply for a new social

security card free of charge with the Social Security Administration office.

• To correct a mistake on a birth certificate or marriage license (for example, incorrect or

misspelled name or misstatement of gender), you should contact the State Registrar of Vital

Statistics directly regarding these changes.

Note

: This packet contains forms for both an adult and minor name change. While the forms may look similar,

please be sure to use th

e proper forms when filing. If there an active restraining order between you and the non

-

party parent, you may contact the Family Court for further instructions.

Note: These materials have been prepared by the New Jersey Administrative Office of the Courts for use by self-represented

litigants. The guides, instructions, and forms will be periodically updated as necessary to reflect current New Jersey statutes and

court rules. The most recent version of the forms will be available at the county courthouse or on the Judiciary’s Internet site

njcourts.gov

. However, you are ultimately responsible for the content of your court papers.

Completed forms are to be submitted to the county where you are filing your case. A list of Family

Division Offices is provided at the customer counter or at njcourts.gov.

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Things to Think About Before You Represent Yourself in Court

Try to Get a Lawyer

The court system can be confusing and it is a good

idea to get a lawyer if you can. The law, the proofs

necessary to present your case, and the procedural

rules governing cases in the Family Division are

complex. It is recommended that you make every

effort to obtain the assistance of a lawyer. If you

cannot afford a lawyer, you may contact the legal

services program in your county to see if you

qualify for free legal services. Their telephone

number can be found online under “Legal Aid” or

“Legal Services.”

If you do not qualify for free legal services and need

help in locating an attorney, you can contact the bar

association in your county. Most county bar

associations have a Lawyer Referral Service. The

County Bar Lawyer Referral Service can supply

you with the names of attorneys in your area willing

to handle your particular type of case and will

sometimes consult with you at a reduced fee. There

are also organizations of minority lawyers

throughout New Jersey, as well as organizations of

lawyers who handle specialized types of cases. Ask

your county court staff for a list of lawyer referral

services that include these organizations.

If you decide to proceed without an attorney, these

materials explain the procedures that must be

followed to have your papers properly filed and

considered by the court.

What You Should Expect If You Represent

Yourself

While you have the right to represent yourself in

court, you should not expect special treatment, help

or attention from the court. The following is a list

of some things court staff can and cannot do for

you. Please read it carefully before asking court

staff for help.

• We can explain and answer questions about

how the court works.

• We can tell you what the requirements are to

have your case considered by the court.

• We can give you some information from your

case file.

• We can provide you with samples of court

forms that are available.

• We can provide you with guidance on how to

fill out forms.

• We can usually answer questions about court

deadlines.

• We cannot give you legal advice. Only your

lawyer can give you legal advice.

• We cannot tell you whether or not you should

bring your case to court.

• We cannot give you an opinion about what will

happen if you bring your case to court.

• We cannot recommend a lawyer, but we can

provide you with the telephone number of a

local lawyer referral service.

• We cannot talk to the judge for you about what

will happen in your case.

• We cannot let you talk to the judge outside of

court.

• We cannot change an order issued by a judge.

Keep Copies of All Papers

Make and keep copies of all completed forms and

documents related to your case.

Name Change – Family Part

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Overview

The following is a brief overview of the process for filing for a name change by a court. There are three basic

steps that you must take to file for a name change:

1. You must fill out forms to send to the court with a filing fee (even if you are changing the names of multiple

family members, there is only one fee). The forms are contained in this packet and include a Verified

Complaint, a Certification of Confidential Information for Name Change, an Order Fixing Date of Hearing,

a Final Judgment, and a Final Judgment Addendum. (There are two copies of each form: one to be used for

an adult and one to be used for a minor).

Please note: When filing for a name change a separate form must be submitted for each party. A separate

docket number is assigned for each name change filed.

2. When the court returns the Verified Complaint, Certification of Confidential Information for Name Change

and the Order Fixing Date of Hearing to you, the forms will contain a docket number and will tell you in

which newspaper you must publish the date of hearing. You must contact the newspaper to have the Order

Fixing Date of Hearing published at least two weeks before the hearing date, and you must notify other

interested parties. You must also send the Order Fixing Date of Hearing to the Director of the Division of

Criminal Justice via certified and regular mail at least 20 days before the hearing. You will have to provide

the court with proof that the appropriate parties have been notified of your intent to file for a name change

for yourself and/or your minor child.

3. At the time of the hearing, you will have to present proof of current name(s) for you and/or your child.

After you appear in court at the hearing, you will have to publish the Final Judgment in the newspaper. You

will also have to send copies of the certified Final Judgment with the Final Judgment Addendum attached,

to the Registrar of Vital Statistics and Department of Treasury within 45 days after the date of the Judgment.

If you and/or your child have a driver’s license, you will have to present a copy of the certified Final

Judgment in person to the Motor Vehicle Commission.

4. You must send a certified copy with a raised seal of the Final Judgment with the Final Judgment Addendum

attached, to the Department of Treasury within 45 days of the date of the Judgment.

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Definitions of Words Used in This Packet

Affidavit of Publication - An affidavit of publication is a sworn statement made by a newspaper stating that

the newspaper has published the information regarding the name change for you and/or your child.

Certification - A certification is a written statement you make when you file your papers with the court in

which you state that all the information contained in the papers is true to the best of your knowledge.

Docket Number - A docket number is the number the court assigns to your case so that it may be identified

and located easily. Once you have a docket number, you must include it on all your communications with the

court. Note: each name change filed will have its own docket number.

File - To file means to give the appropriate forms and fee to the court to begin the court’s consideration of

your case.

Final Judgment - The final judgment is a document signed by the judge which orders the name to be

changed.

Order Fixing Date of Hearing - An order fixing the date of hearing is a signed paper from the judge

indicating the date when you must come to court on your case and stating the name of the newspaper in

which you will have to publish your hearing date.

Proof of Mailing - Proof of mailing is the green card you get back from the Post Office that proves that the

material you sent by certified mail, return receipt requested, was received by the person to whom you sent it.

Verified Complaint - A verified complaint is a document in which you tell the court the facts of your case

and state what relief you want the court to give you. You certify that the information is true to the best of

your knowledge.

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The numbered steps listed below tell you what forms you will need to fill out and what to do with them. Each form should be typed or

printed clearly on 8 ½ “x 11” white paper only. Forms may not be filed on a different size or color paper.

Steps to Obtain a Court Order to Change Your Name

STEP 1: Fill out the Verified Complaint

and Certification of Confidential Information for

Name Change (Forms A and A1 - Adult; Forms F

and F1 - Minor) for each person filing with the court.

The Verified Complaint (Form A - Adult; Form F -

Minor) tells the court the current name of you/your

child, what you want to change it to, and why you want

it changed. Be sure to fill out a separate form for each

person. If you and/or your child have ever been

convicted of a crime, or if there are charges pending

against you and/or your child, you must include this

information in the Verified Complaint. You must sign

the certification that states that the information in the

complaint is true to the best of your knowledge.

The Certification of Confidential Information for Name

Change (Form A1 - Adult, Form F1 - Minor), which

contains confidential information such as social security

numbers, must also be completed and signed. You must

complete one Certification of Confidential Information

for Name Change for each person.

STEP 2: Fill out the Order Fixing Date of Hearing,

Final Judgment and Final Judgment Addendum

(Forms B, C and C1 - Adult, Forms G, H, H1 -

Minor) for each person filing with the court.

Enter the information requested. Note that there are

places on the Order Fixing Date of Hearing, Final

Judgment and Final Judgment Addendum that the court

will complete.

STEP 3: Make a check or money order payable to

Treasurer, State of New Jersey in the amount of

$250.00.

This is the fee for filing your papers.

Note: If you are changing the names of multiple

family members, the $250.00 fee covers all name

change applications.

STEP 4: Check your completed forms and make

copies.

Check your forms and make sure they are complete.

Remove all instruction sheets. Make sure you have

signed all the forms wherever necessary. You also need

to make two copies of each form. One copy will be sent

to the court; the other is for your records.

Checklist - In Step 5 you will be directed to mail or

deliver your documents to the court. The following

checklist will help insure your package is complete:

The original of each of the forms you filled

out: Verified Complaint (Form A - Adult

and/or Form F - Minor), Certification of

Confidential Information for Name Change

(Form A1 - Adult and/or Form F1 - Minor),

Order Fixing Date of Hearing (Form B -

Adult and/or Form G - Minor), Final

Judgment (Form C - Adult and/or Form H -

Minor), and the Final Judgment Addendum

(Form C1 - Adult and/or Form H1 - Minor).

One copy of each of these forms: Verified

Complaint, Certification of Confidential

Information for Name Change, Order Fixing

Date of Hearing, Final Judgment, and the

Final Judgment Addendum.

The filing fee in the amount of $250. It

must be a check or money order payable to

the Treasurer, State of New Jersey.

A stamped envelope addressed to yourself

so that the court will be able to return the

forms to you. Be sure to include adequate

postage.

STEP 5: Mail or deliver the forms to the court.

Mail or deliver to the court the original plus one copy of

all the forms: Verified Complaint (Form A - Adult

and/or Form F - Minor), Certification of Confidential

Information for Name Change (Form A1 - Adult and/or

Form F1 - Minor), Order Fixing Date of Hearing (Form

B - Adult and/or Form G - Minor), Final Judgment

(Form C - Adult and/or Form H - Minor), and the Final

Judgment Addendum (Form C1 - Adult and/or Form H1

- Minor) along with a self-addressed stamped envelope

and the filing fee. The court address can be found on

the Judiciary’s website, njcourts.gov. If you mail the

papers, we recommend that you use certified mail,

return receipt requested.

STEP 6: Review copies returned from court.

The court will return copies of the Verified Complaint,

Certification of Confidential Information for Name

Change and Order Fixing Date of Hearing to you. Once

you receive them, there will be a docket number written

on all the copies (each name change filed will have its

own docket number). The docket number is very

important because it identifies your case. It also lets the

court know how to find your case. You must use the

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docket number on all future papers you send to the

court about your case. The court will fill in the date on

the Order Fixing Date of Hearing. That is the day you

will appear before the judge to get the Final Judgment.

The court will also indicate the name of a newspaper in

which you are to have the notice of your hearing date

published.

If you and/or your child Do Not have pending criminal

or delinquent charges in New Jersey skip to Step 8.

STEP 7: If you and/or your child have criminal or

delinquent charges pending, notify the State or

County Prosecutor of the Application for a Name

Change.

If you and/or your child have criminal or delinquent

charges pending in New Jersey, you must send a copy of

the Verified Complaint, Certification of Confidential

Information for Name Change and Order Fixing Date of

Hearing by regular mail and certified mail, return

receipt requested to the Prosecutor of the county where

the matter is being heard at least 20 days before the

hearing.

If the charges were brought by the Office of the

Attorney General, you must send a copy of the Verified

Complaint, Certification of Confidential Information for

Name Change and Order Fixing Date of Hearing to the

Director of the Division of Criminal Justice as set forth

in Step 8.

STEP 8: Notify the State of the Application for a

Name Change for each person filing with the court.

You must send a copy of the Order Fixing Date of

Hearing by regular mail and certified mail, return receipt

requested, to the Director of the Division of Criminal

Justice in Trenton, New Jersey, at least 20 days before

the hearing. Mail a copy to:

Director, Division of Criminal Justice

ATTN: Records and Identification Section

R. J. Hughes Justice Complex

25 W. Market Street

P. O. Box 085

Trenton, NJ 08625-0085

Note: If you and/or your child have criminal charges

pending against them in New Jersey, you must also

include a copy of the Verified Complaint and

Certification of Confidential Information for Name

Change.

STEP 9: Publish the Order Fixing Date of Hearing.

In the Order Fixing Date of Hearing that you receive

back from the court, the judge will have specified the

name of a local newspaper. You must have the Order

Fixing Date of Hearing published (for each person) in

the newspaper the judge chooses. It must be published

in the newspaper at least two (2) weeks before the date

of the hearing. You should talk to the newspaper about

how to publish legal notices. Included in this packet are

sample newspaper notices for both adult (Form E) and

minor (Form J).

STEP 10: Send the Affidavit of Publication to the

court.

Once you have published the Order Fixing Date of

Hearing, the newspaper will send you an Affidavit of

Publication, which is proof that you had the newspaper

publish the Order Fixing Date of Hearing. You must

send the original of this Affidavit of Publication

document to the court immediately after you get it from

the newspaper. Keep a copy of it for your files.

STEP 11: Notify minor child’s other parent.

If you are changing the name of a child who is under the

age of 18 years and the child’s other parent does not

reside with you, you must send a copy of the Verified

Complaint and the Order Fixing Date for Hearing to the

last known address of the child’s other parent. This

must be sent by regular mail and certified mail, return

receipt requested. Your post office can tell you how to

do this.

STEP 12: Complete Proof of Mailing (Form D -

Adult, Form I - Minor) and send to court.

After you have mailed the required copies of the

Verified Complaint, Certification of Confidential

Information for Name Change and/or signed Order

Fixing Date for Hearing, the post office will send you a

green card (called a certified mail receipt) for each

recipient that shows the mail was delivered. Once you

get it back, fill out the form called Proof of Mailing

(Form D - Adult, Form I - Minor) and select the

appropriate response as to whether you sent the forms to

the Division of Criminal Justice, or both the Division of

Criminal Justice and the Prosecutor. Be sure to attach

the original green certified mail receipt(s) to the original

Proof of Mailing. Send the Proof of Mailing to the

court. Keep a copy of it for your files.

STEP 13: Appear in court on the date set by the

judge for your hearing.

Be sure to bring with you proof of current name(s) for

you and/or your child.

STEP 14: Publish the Final Judgment in the

newspaper.

After the hearing, the court will enter the original Final

Judgment signed by the judge, as well as the Final

Judgment Addendum. As soon as you receive your copy

of the Final Judgment, you must send it to be published

in the newspaper chosen by the judge (do not send a

copy of the Final Judgment Addendum to the

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newspaper). The newspaper published version of the

Final Judgment will not include social security numbers.

The Final Judgment must appear in the newspaper no

more than 20 days after the date on the judgment. After

you have it published, the newspaper will send you an

original Affidavit of Publication.

STEP 15: Send the Affidavit of Publication to the

court.

As soon as you receive the Affidavit of Publication from

the newspaper, send the original to the Court as proof

that you had the newspaper publish the Final Judgment.

Keep a copy for your records.

STEP 16: Order Certified Copies with a Raised Seal

of the Final Judgment and the Final Judgment

Addendum from the court.

You will need a certified copy with a raised seal of the

Final Judgment with the Final Judgment Addendum

attached, to be sent to both the Department of Treasury

(Step 17) and the Registrar of Vital Statistics (Step 18).

If you and/or your child are a licensed driver, a

registered owner of a vehicle, or possess a handicapped

or non-driver identification card, you must also present a

certified copy with a raised seal of the Final Judgment

with the Final Judgment Addendum attached, in person,

at any Motor Vehicle Agency or Regional Service

Center (Step 19). The fee for each certified copy with a

raised seal is $25.00.

STEP 17: Send a copy of the certified Final

Judgment with the Final Judgment Addendum to the

Department of Treasury

You must send a certified copy with a raised seal of the

Final Judgment with the Final Judgment Addendum

attached, to the Department of Treasury within 45 days

after the date of the Judgment. You must include a

check or money order payable to the Treasurer, State of

New Jersey, in the amount of $50. (Note: if you are

changing the names of multiple family members, include

the fee for each member.)

Mail the certified copy of the Final Judgment with the

Final Judgment Addendum attached, with the check or

money order and a stamped self-addressed envelope to:

Department of Treasury

Division of Revenue

Judgment Name Change Unit

P. O. Box 453

Trenton, NJ 08646

STEP 18: Notify the Registrar of Vital Statistics of

the State.

You must send a certified copy with a raised seal of the

Final Judgment with the Final Judgment Addendum

attached, to the Registrar of Vital Statistics of the State

in which you and/or your child was born. The Office of

the Registrar is located in the capital city of the State in

which you and/or your child was born. Check to see if

the office requires a fee. If you and/or your child were

born in New Jersey, the address for this office is:

Bureau of Vital Statistics

Attn: Vital Records Modifications Unit

P. O. Box 370

Trenton, NJ 08625

In New Jersey, there is a $2.00 fee to process the legal

name change. There is also a $25.00 fee if you want to

receive a corrected birth certificate, marriage license,

civil union and/or domestic partnership record. There is

a $2.00 fee for each additional copy of the same

certificate. Checks or money orders should be made

payable to the Treasurer, State of New Jersey (make sure

to account for each name change granted).

STEP 19: Notify the Motor Vehicles Commission.

If you and/or your child are a licensed driver, a

registered owner of a vehicle, or possess a handicapped

or non-driver identification card, you must present the

Final Judgment with the Final Judgment Addendum, in

person, at any Motor Vehicle Agency or Regional

Service Center within two weeks after the effective date

set forth in the Final Judgment.

NOTE: The effective date is not the date of the

hearing or the date the Final Judgment was signed.

The effective date is the date you and/or your child

may begin using the assumed name(s).

Additional information is available at njmvc.gov

regarding the list of acceptable documents to satisfy the

6 points of identification.

Name Change – Family Part

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Adult Name Change Forms

For use if you are changing your name at the same time you

are changing the name of a minor child.

Form A

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Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Verified Complaint Including

Certification of Plaintiff for Name

Change

In the Matter of the Application of:

Your Name

To Assume the Name of:

Name you wish to assume

The plaintiff, , whose place of residence is

(your name, first, middle, last)

, in the City of , County of

(street address) (city)

, in the State of New Jersey says:

1. I am the Plaintiff in this matter.

2. My current legal name is

(your name, first, middle, last)

3.

My social security number can be found in the attached Certification of Confidential Information for

Name Change.

4. I was born on .

(month, day, year)

5. I have since birth been identified by the following names: (first, middle, last)

6. I (check one) have have not been married.

7.

I (check one) have have never been convicted of a crime, and have no criminal charges

pending against me, except: (please supply county, municipality, nature, date of crime and/or pending charges)

8.

This application (check one) is is not being made with the intent to avoid creditors or criminal

prosecution or for other fraudulent purpose.

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Form A

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9.

I (check one) have have no unsatisfied judgments of record, or suits pending against me,

except: (enter any recorded judgments or pending suits)

10. I request this name change for the following reasons:

11. I (check one) have have not made any previous applications to assume another name.

12.

I (check one) do do not have any pending applications for a name change in any other court

or jurisdiction to the best of my knowledge and belief, except: (enter the state, county and docket number(s)

of any pending applications)

13. Will you require

An interpreter?

Yes

No

Indicate language:

An accommodation for disability?

Yes

No

Indicate accommodation:

14.

I understand that I must advise the court if there are any changes in the facts stated in this Verified

Complaint.

WHEREFORE, plaintiff demands judgment pursuant to N.J.S.A. 2A:52-1 to -4.

Signature of Plaintiff

Certification

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing

statements made by me are willfully false, I am subject to punishment.

Dated

Signature of Plaintiff

Form A1

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Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Certification of Confidential Information

for Name Change

In the Matter of the Application of:

Your Name

To Assume the Name of:

Name you wish to assume

In support of my application for a change of name, I, ,

(your name, first, middle, last)

state the following:

1. I am the Plaintiff in this matter and currently reside at ,

(street address)

in the City of , County of , in the State of New Jersey.

(City) (County)

2. My social security number is .

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing

statements made by me are willfully false, I am subject to punishment.

Dated

Signature of Plaintiff

Form B

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Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Order Fixing Date of Hearing

In the Matter of the Application of:

Your Name

To Assume the Name of:

Name you wish to assume

Application being made to the Court by ,

(your name, first, middle, last)

for a judgment authorizing the applicant to assume another name and for the entry of an order fixing a

date for the hearing of such application,

DO NOT WRITE BELOW THIS LINE THE COURT WILL COMPLETE

IT IS ON THIS day of , 20 , ORDERED that the day of

, 20 , at

a.m., or as soon thereafter as the matter can be heard, at the courthouse

in the City of

, County of , State of New Jersey, be fixed as the

time and place

for the hearing of such application and of any objections that may be made thereto.

IT IS FURTHER ORDERED that a notice of such application be published in

once, at least two (2) weeks preceding the

date set for the hearing.

J.S.C.

NOTE:

A copy of the Order Fixing Date of Hearing must be sent via regular mail and certified mail to

the

newspaper for publication and served on the Director of the Division of Criminal Justice. If there

are criminal charges pending, copies of the Verified Complaint, Certification of Confidential

Information for Name Change and Order Fixing Date of Hearing m

ust be sent via regular mail and

certified mail and served on the County Prosecutor and/or the Office of the Attorney

General.

Form C

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Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Final Judgment

In the Matter of the Application of:

Your Name

To Assume the Name of:

Name you wish to assume

, having made application to this Court by duly

(your name, first, middle, last)

verified complaint for a judgment authorizing the applicant to assume the name of

, and it appearing to the Court that all the provisions of

(name you wish to assume)

N.J.S.A. 2A:52-1-4 and the Current N.J. Court Rules relating thereto have been complied with:

IT IS ON THIS day of , 20 , ORDERED and ADJUDGED that

(leave blank for the court to complete)

, who was born on , and whose social

(your name, first, middle, last) (month, day, year)

security number is contained in the attached Final Judgment Addendum, be and hereby is authorized to

assume the name of , effective ,

(name you wish to assume) (leave blank for the court to complete)

(NOTE: This is the date you may begin using your assumed name), and

DO NOT WRITE BELOW THIS LINE THE COURT WILL COMPLETE

IT IS FURTHER ORDERED that within twenty days hereof, plaintiff shall cause a copy of only the

Final Judgment (not the Final Judgment Addendum) to be published once in

and within forty-five days after entry of Judgment, plaintiff shall file proof of

publication

of this Final Judgment with the deputy clerk of the Superior Court (in the county in which you filed

your Verified Complaint

);

IT IS FURTHER ORDERED that the published version of the Final Judgment shall not contain the

social security number of the person

whose name was changed; and

IT IS FURTHER ORDERED that within forty-five days after entry of Judgment, a certified copy of

this Final Judgment, with the Final Judgment Addendum attached, must be sent to the Department of Treasury

pursuant to the provision

s of the Statute and Rules in such case made and provided.

Dated

J.S.C.

Form C1

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Final Judgment Addendum

Pursuant to the Final Judgment dated , ,

(leave blank for the court to complete) (your name, first, middle, last)

whose social security number is , is authorized to assume the name of

.

(name you wish to assume)

This Final Judgment Addendum shall not be published with the Final Judgment or made public in any

form.

Form D

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Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Proof of Mailing

In the Matter of the Application of:

Your Name

To Assume the Name of:

Name you wish to assume

A.

Check the appropriate box(es), below:

On , I, the undersigned, mailed a copy of the Order Fixing Date of Hearing in

accordance with the

Rules of Court to the Division of Criminal Justice of New Jersey, via

certified mail, return receipt requested.

OR

On , I, the undersigned, mailed a copy of the Verified Complaint for Change of

Name, Certification

of Confidential Information for Name Change and Order Fixing Date of

Hearing in accordance with the

Rules of Court to (check all that apply):

the Division of Criminal Justice of New Jersey, via certified mail, return receipt

requested;

the Prosecutor of County, via regular mail and certified mail, return

receipt requested.

B.

Attached are the green return mail receipt(s) for (check all that apply):

the Division of Criminal Justice of New Jersey

the Prosecutor of County

I certify that the foregoing statements made by me are true. I am aware that if any of the

foregoing statements made by me are willfully false, I am subject to punishment.

Dated

Signature

Form E

Promulgated via AJ Memo 11/01/2019, CN 10552 page 16 of 25

Sample Newspaper Notice

In the Matter of the Application of:

Your Name (first, middle, last)

To Assume the Name of:

Name you wish to assume

To Whom it May Concern,

Take notice that the undersigned will apply to County Superior Court

(county where the name change action is filed)

on the day of , 20 , at 9 o’clock in the morning at the courthouse

in the city of , New Jersey, for a judgment

(name of city)

authorizing , to assume the name of

(your name, first, middle, last)

.

(name you wish to assume, first, middle, last)

Your name

Street address

City, State, Zip

Name Change – Family Part

Promulgated via AJ Memo 11/01/2019, CN 10552 page 17 of 25

Minor Name Change Forms

For use if you are changing the name of a minor under the age

of 18. If you are changing the names of multiple children, a

separate form must be filled out for each.

Form F

Promulgated via AJ Memo 11/01/2019, CN 10552 page 18 of 25

Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Verified Complaint Including

Certification of Plaintiff for Name

Change of Minor Child

In the Matter of the Application of:

Your Name (first, middle, last)

To Change the Name of:

Name of Minor Child (first, middle, last)

To:

Name you wish your child to assume

The plaintiff, , whose place of residence is

(your name, first, middle, last)

, in the city of , County of

(street address) (city)

, in the State of New Jersey says:

1. I am the parent/guardian of , and make this application

(child’s name, first, middle, last)

to change my child’s name to .

(name you want your child to assume)

2.

My child’s social security number can be found in the attached Certification of Confidential

Information for Name Change.

3. My child was born on .

(month, day, year)

4.

My child’s other parent/guardian is named . They reside at

.

5. My child is being raised by , and .

6.

My child (check one) has has not been married.

7.

There (check one) are are no unsatisfied judgments of record, or suits pending against my

child, except: (enter any recorded judgments or pending suits)

Form F

Promulgated via AJ Memo 11/01/2019, CN 10552 page 19 of 25

8. This application

(check one)

is

is not being made with the intent to avoid creditors or

criminal prosecution or for other fraudulent purpose.

9. My child (check one) has has not made any previous applications to assume another name.

10. I desire my child to have the name of: .

(first, middle, last)

11. I request this name change for the following reasons:

12. Will you require

An interpreter?

Yes

No

Indicate language:

An accommodation for disability?

Yes

No

Indicate accommodation:

WHEREFORE, plaintiff demands judgment pursuant to N.J.S.A. 2A:52-1 to -4.

Signature of Plaintiff

Certification

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing

statements made by me are willfully false, I am subject to punishment.

Dated

Signature of Plaintiff

Form F1

Promulgated via AJ Memo 11/01/2019, CN 10552 page 20 of 25

Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

In the Matter of the Application of:

Civil Action

Certification of Confidential Information for

Name Change

Your Name (first, middle, last)

To Change the Name of:

Name of Minor Child (first, middle, last)

To:

Name you wish your child to assume

In support of my application for a change of name of my minor child, I, ,

(your name, first, middle, last)

state the following:

1. I am the Plaintiff in this matter and currently reside at ,

(street address)

in the City of , County of , in the State of New Jersey.

(City) (County)

2. My child’s social security number is .

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements

made by me are willfully false, I am subject to punishment.

Dated

Signature of Plaintiff

Form G

Promulgated via AJ Memo 11/01/2019, CN 10552 page 21 of 25

Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Order Fixing Date of Hearing

In the Matter of the Application of:

Your Name (first, middle, last)

To Change the Name of:

Name of Minor Child (first, middle, last)

To:

Name you wish your child to assume

Application being made to the Court by ,

(your name, first, middle, last)

for a judgment authorizing the applicant’s minor child to assume another name and for the entry of an

order fixing a date for the hearing of such application,

DO NOT WRITE BELOW THIS LINE THE COURT WILL COMPLETE

IT IS ON THIS day of , 20 , ORDERED that the day of

, 20 , at

a.m., or as soon thereafter as the matter can be heard, at the courthouse

in the City of

, County of , State of New Jersey, be fixed as the

time and place for the hearing of such application and of any objections that may be made thereto.

IT IS FURTHER ORDERED that a notice of such application be published in

once, at least two (2) weeks preceding the

date set for the

hearing.

J.S.C.

NOTE:

Copies of the Verified Complaint and Order Fixing The Date Of The Hearing must be sent to

the

other parent of the minor child via regular mail and certified mail. A copy of the Order Fixing Date

of Hearing must be sent via

regular mail and certified mail to the newspaper for publication and served

on the Director of the Division of Criminal Justice. If there are criminal charges pending, copies of the

Verified Complaint, Certification of Confidential Information for Name Ch

ange and Order Fixing Date

of Hearing must be sent via regular mail and certified mail and served on the County Prosecutor and/or

the Office of the Attorney General.

Form H

Promulgated via AJ Memo 11/01/2019, CN 10552 page 22 of 25

Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

Civil Action

Final Judgment

In the Matter of the Application of:

Your Name (first, middle, last)

To Change the Name of:

Name of Minor Child (first, middle, last)

To:

Name you wish your child to assume

, having made application to this Court by duly

(your name, first, middle, last)

verified complaint for a judgment authorizing the applicant’s minor child to

assume the name of , and it appearing to the Court that all the

(name you wish your child to assume)

provisions of N.J.S.A. 2A:52-1-4 and the Current N.J. Court Rules relating thereto have been complied with:

IT IS ON THIS day of , 20 , ORDERED and ADJUDGED that

(leave blank for the court to complete)

, who was born on , and whose social security

(your child’s name, first, middle, last) (month, day, year)

number is contained in the attached Final Judgment Addendum, be and hereby is authorized to assume the name

of , from and after , and

(name you wish your child to assume) (leave blank for the court to complete)

DO NOT WRITE BELOW THIS LINE THE COURT WILL COMPLETE

IT IS FURTHER ORDERED that within twenty days hereof, plaintiff shall cause a copy of only the

Final

Judgment (not the Final Judgment Addendum) to be published once in

and within forty-five days after entry of Judgment, plaintiff shall file proof of

publication of this Final Judgment with the deputy clerk of

the Superior Court (in the county in which you filed

your Verified Complaint);

IT IS FURTHER ORDERED that the published version of the final judgment shall not contain the

minor child’s social security number.

IT IS FURTHER ORDERED that within forty-five days after entry of Judgment, a certified copy of

this Final Judgment, with the Final Judgment Addend

um attached, must be sent to the Department of Treasury

pursuant to the provisions of the Statute and Rules in such case made and provided.

Dated

J.S.C.

Form H1

Promulgated via AJ Memo 11/01/2019, CN 10552 page 23 of 25

Final Judgment Addendum

Pursuant to the Final Judgment dated , ,

(leave blank for the court to complete) (your child’s name, first, middle, last)

whose social security number is , is authorized to assume the name of

.

(name you wish your child to assume)

This Final Judgment Addendum shall not be published with the Final Judgment or made public in any

form.

Form I

Promulgated via AJ Memo 11/01/2019, CN 10552 page 24 of 25

Superior Court of New Jersey

Name

Chancery Division - Family Part

County

Street Address

Docket No.

City, State, Zip

(To be filled in by the court)

Telephone Number

In the Matter of the Application of:

Civil Action

Proof of Mailing

Your Name (first, middle, last)

To Change the Name of:

Name of Minor Child

To:

Name you wish your child to assume

Check the appropriate box(es), below:

On , I, the undersigned, mailed a copy of the Order Fixing Date of Hearing in accordance

with the

Rules of Court to the Division of Criminal Justice of New Jersey, via certified mail, return

receipt

requested.

OR

On , I, the undersigned, mailed a copy of the Verified Complaint for Change of Name,

Certification of Confidential Information for Name Change and Order Fixing Date of Hearing in

accordance with the

Rules of Court to: (check all that apply):

the Division of Criminal Justice of New Jersey, via certified mail, return receipt requested;

the Prosecutor of County, via regular mail and certified mail, return receipt

requested.

the non-party parent of the minor child at his or her last known address, via certified mail,

return receipt requested;

Note

: Attached are the green return mail receipt(s) for (check all that apply):

the Division of Criminal Justice of New Jersey

the Prosecutor of County

the non-party parent of the minor child;

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements

made by me are willfully false, I am subject to punishment.

Dated

Signature

Form J

Promulgated via AJ Memo 11/01/2019, CN 10552 page 25 of 25

Sample Newspaper Notice

In the Matter of the Application of:

Your Name (first, middle, last)

To Change the Name of:

Name of Minor Child (first, middle, last)

To:

Name you wish your child to assume

To Whom it May Concern,

Take notice that the undersigned will apply to County Superior Court

(county where the name change action is filed)

on the day of , 20 , at 9 o’clock in the morning at the courthouse

in the city of , New Jersey, for a judgment

(name of city)

authorizing , to assume the name of

(name of child, first, middle, last)

.

(name you wish your child to assume, first, middle, last)

Your name

Street address

City, State, Zip

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