Form C- Rev 02/2018 Page 5
The following must be submitted to the Lieutenant Governor’s Office.
BIRTH CERTIFICATE OR CERTIFICATE OF NATURALIZATION- a certified copy of
your original birth certificate from the state in which you were born. Certification of the
birth certificate must not be older than 90 days prior to submission of your name change
Petition. Original Certificate of Naturalization (if applicable) must also be submitted.
If you are not a U.S. Citizen, please provide a photocopy of your passport AND either of the
following: (1) foreign birth certificate, which must be translated into English and notarized;
(2) family register; or (3) alien registration card. Parents will submit a photocopy of their
PETITION- notarized by a State of Hawaii notary public within 30 days prior to submission
of name change forms.
FACT SHEET- completed fact sheet.
NOTICE OF CHANGE OF NAME- one original
ORDER- original plus five (5) copies
NON-REFUNDABLE FILING FEE- Money Order or Cashier’s Check made payable to the
Office of the Lieutenant Governor in the amount of $50.00. No personal checks will be
accepted. Cash will only be accepted when petitioner hand carries documents into the Office
of the Lieutenant Governor.
SUPPORTING DOCUMENTS- Marriage Certificate, Divorce Decree, Death Certificate,
Paternity Documents, Adoption Decree, Guardianship documents, prior name change decree,
if applicable (copies acceptable).
CONSENT FORM- signed by minor child over 10 years of age
ENVELOPES- Please enclose 2 self-addressed stamped envelopes:
1 ea. #10 (regular) envelope with 1 first class stamps
1 ea. large flat manila envelope with $2.00 stamps
CORRECTIONS- Petitions with liquid paper corrections must be initialed by the notary
NOTICE REGARDING LEGAL ADVICE
The Office of the Lieutenant Governor cannot render legal advi
ce regarding name changes. We can only
answer questions related to the procedures involved in processing name changes. IF YOU HAVE
LEGAL QUESTIONS, YOU SHOULD CONTACT AN ATTORNEY.
A PETITION CONTAINING TYPOGRAPHICAL ERRORS, MISSING INFORMATION
OR OTHERWISE NOT IN CONFORMANCE WITH THESE INSTRUCTIONS WILL NOT
BE ACCEPTED FOR PROCESSING.