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NAME CHANGE (Maricopa County Telecommunications)

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© Superior Court of Arizona in Maricopa County
ALL RIGHTS RESERVED
CVNCA1 –
5292 - 120120
NAME CHANGE
for an ADULT
Who Has No Minor Children
1
Forms and Instructions
Law Library Resource Center
NAME CHANGE FOR AN
ADULT WITH NO MINOR CHILDREN
CHECKLIST
You may use this packet if the following factors apply to your situation:
You are a resident of the county where you are filing this request.
You want to ask the Court to change your name, AND
You are an adult 18 years or older, and you are not the parent of any minor children, AND
You are prepared, under penalty of perjury, to inform the Court whether you have ever been
convicted of a felony, and whether there are any pending charges against you for a felony or
other offense involving false statements or misrepresentation of identity, AND
You understand the change of name will neither harm your rights nor release you from any
obligations or liabilities incurred under your current name, AND
You are not changing your name to that of another person for the purpose of committing any
crime or furthering any offense involving fraud or misrepresentation of identity.
NOTE: You do NOT need to request a name change through the Court if you get
married and want to use your spouse’s last name.
READ ME: Consulting a lawyer before filing documents with the court may help
prevent unexpected results. A list of lawyers you may hire to advise you on handling
your own case or to perform specific tasks, as well as a list of court-approved mediators
can be found on the Law Library Resource Center website.
© Superior Court of Arizona in Maricopa County CVNCA1k-020117
ALL RIGHTS RESERVED Page 1 of 1
© Superior Court of Arizona in Maricopa County Page 1 of 1 CVNCA1t 120120
ALL RIGHTS RESERVED
Law Library Resource Center
Request a change of name for an adult with no minor children
This packet contains court forms and instructions to file an application to change the name of an
adult who is NOT the parent of any minor children. The documents should appear in order as
listed. Items in BOLD are forms that you will need to file with the Court. Non-bold items are
instructions or procedures. Do not copy or file those pages!
Order
File Number
Title
# Pages
1 CVNCA1k Checklist: “You may use these forms if . . .” 1
2 CVNCA1t Table of Contents (this page) 1
3 CVNCA10p Procedures: How to File a for a Name Change 5
4 CV10f “Civil Cover Sheet” 3
5 CVNC11f “Application for Change of Name for an Adult” 4
6 CVNC18f
“Notice of Hearing Regarding Application for Change of
Name”
1
7 CVNC16f
“Marital Waiver of Notice” (Use Only if Currently Legally
Married)
1
8 CVNC24f “Affidavit of Service by Certified Mail” 1
9 CVNC81f “Order Changing Name for an Adult” 2
10 CVNC81f “Order Changing Name for an Adult” (bring both to court) 2
The documents you have received are copyrighted by the Superior Court of Arizona in Maricopa
County. You have permission to use them for any lawful purpose. These forms shall not be used
to engage in the unauthorized practice of law. The Court assumes no responsibility and accepts
no liability for actions taken by users of these documents, including reliance on their contents.
The documents are under continual revision and are current only for the day they were received.
It is strongly recommended that you verify on a regular basis that you have the most current
documents.
LAW LIBRARY RESOURCE CENTER
PROCEDURES: HOW TO FILE FOR A CHANGE OF NAME
FOR AN ADULT WITH NO MINOR CHILDREN
STEP 1: Fill out the “Civil Cover Sheet” and check box 152 for “Change of Name” on page 2.
STEP 2: Fill out the “Application for Change of Name for an Adult.” You or your attorney must
complete the Application for your name change.
STEP 3: PHOTOCOPY: Make two (2) photocopies of your Application.
STEP 4: GO to the Clerk of Court to file your Application. The Court is open from 8 a.m. to 5 p.m.
Monday through Friday. You should go to the Clerk of Court at least two hours before closing.
Choose one of the following Superior Court locations:
Downtown Phoenix Northeast Court Facility
201 W. Jefferson St. 18380 North 40
th
Street
Phoenix, AZ 85003 Phoenix, Arizona 85032
Northwest Court Facility* Southeast Court Facility
14264 West Tierra Buena Lane 222 East Javelina Avenue, 1
st
Floor
Surprise, Arizona 85374 Mesa, Arizona 85210-6201
* You may file here but your hearing will be set at a different location.
STEP 5: DELIVER your APPLICATION and FILING FEE to the Clerk of Court. Give the Court Clerk the
following:
• One (1) Civil Cover Sheet
• One (1) Original Application for Name Change
• Two (2) Photocopies of the Application
• Filing Fee ($) Payment. A list of current fees is available from the Law Library Resource
Center and from the Clerk of Court’s website.
If you cannot afford the filing fee and/or the fee for having the papers served by the Sheriff
or by publication, you may request a deferral (payment plan) when you file your papers with
the Clerk of the Court. Deferral Applications are available at no charge from the Law Library
Resource Center.
• WAIT for the Clerk to “date stamp” BOTH COPIES of your Application and RETURN
the copies to you.
© Superior Court of Arizona in Maricopa County CVNCA10p - 051517
ALL RIGHTS RESERVED Page 1 of 5
STEP 6: SCHEDULE your HEARING with Court Administration.
• Contact Court Administration by using the appropriate telephone number below, at least
four (4) business days after you file your Application for Name Change, to obtain the date,
time, place of your hearing, and presiding Commissioner’s name.
• Telephone the number listed below between the hours of 9 a.m. -12 noon or 1 p.m. –
4 p.m.:
If you filed you Application for Name Change at:
o 201 W. Jefferson, Phoenix, call 602-506-1497
o 18380 North 40
th
Street, Phoenix, call 602-506-1497
o 222 East Javelina Avenue, Mesa, 1
st
Floor, call 602-506-2023
o 14264 West Tierra Buena Lane, Surprise, call 602-506-1497
*
*Applications may be filed at Northwest Court Facility, but the hearings will be held at one of the
other locations.
STEP 7: COMPLETE AND DELIVER THE “Notice of Hearing.” The “NOTICE OF HEARING Regarding
Application for Change of Name” is how you must inform a person concerned with or affected by
your name change. If you are married, you MUST inform your spouse of your name change.
• Fill out the “NOTICE OF HEARING Regarding Application for Change of Name” form in this
packet. Use the information you learned from the telephone call with Court Administration to
fill in the date, time and location of the hearing.
• PHOTOCOPY the completed “NOTICE OF HEARING” – make at least two (2) photocopies.
(You may need more than two (2) copies if you choose to inform more than one person
concerned with or affected by your name change.)
• Deliver the completed “NOTICE OF HEARING” form to one of the Clerk of Court locations
listed in STEP 4 above.
STEP 8: NOTIFY ANY INTERESTED PERSON. An interested person is a person concerned with or
affected by your name change.
A Note about Response Times
If you serve an interested party notice by personal service or they agree to signing
and notarizing an “Acceptance of Service,” the party will have twenty (20) days after
service to file a response. However, if you ask a party to sign and notarize a “Waiver
of Notice” and they agree, the party is allowed more time to respond. The party has
sixty (60) days to respond after the request for waiver was sent, or ninety (90) days
after it was sent outside the United States. A.R.C.P. (12)(a)(1)(A). The “Affidavit of
Service,” “Acceptance of Service” or “Waiver of Notice” must be signed and filed with
the court as proof.
A. IF YOU ARE NOT MARRIED: You must provide NOTICE to any person (Interested
Party) concerned with or affected by your name change. There are at least two ways to
provide NOTICE to an Interested Party:
© Superior Court of Arizona in Maricopa County CVNCA10p - 051517
ALL RIGHTS RESERVED Page 2 of 5
(1) HAND DELIVERY
• GIVE the Interested Party (1) date stamped copy of your Application, and (1) Notice of
Hearing which states the date, time, and place of the hearing.
• ASK the Interested Party to SIGN AN “Acceptance of Service” form (Available at the
Law Library Resource Center). This “Acceptance of Service” form is your PROOF of
NOTICE.
• NOTARIZE: Take the Interested Party and the completed, “Acceptance of Service” form
to a Notary and have the Interested Party SIGN the FORM before the Notary.
• TAKE the NOTARIZED “WAIVER” form to the hearing.
(2) CERTIFIED MAIL DELIVERY: MUST BE DONE AT LEAST 30 DAYS BEFORE THE
HEARING:
• MAIL by CERTIFED RETURN RECEIPT the following to the Interested Party: (1) date
stamped copy of your Application, and (1) Notice of Hearing which states the date,
time, and place of the hearing.
• Your PROOF of Notice for this “MAIL” step is the postcard you receive in the mail
showing delivery.
• Fill Out the “Affidavit of Service” form in this packet.
• NOTARIZE: Take the completed, “Affidavit of Service” form to a Notary and SIGN the
FORM before the Notary.
• TAKE (1) NOTARIZED “Affidavit” form and (1) Returned Postcard to the hearing
B. IF YOU ARE MARRIED:
1. If SPOUSE AGREES WITH THIS NAME CHANGE APPLICATION
• GIVE your spouse (1) date stamped copy of your Application, and (1)
Notice of Hearing which states the date, time, and place of the hearing.
• ASK your Spouse to COMPLETE the form from this packet called
“Marital Waiver of Notice.” This “Marital Waiver” form is your PROOF of
NOTICE.
• NOTARIZE: Take your Spouse and the completed, “Marital Waiver of
Notice” form to a Notary and have your Spouse SIGN the FORM before
the Notary.
• TAKE the NOTARIZED “MARITAL WAIVER” form to the hearing.
2. If SPOUSE DOES NOT AGREE with this Name Change Application -OR- YOU ARE
NOT SURE IF SPOUSE AGREES, choose either Option (a), or Option (b):
Option (a): HAND DELIVERY
• GIVE your spouse (1) date stamped copy of your Application, and (1)
Notice of Hearing which states the date, time, and place of the hearing.
• ASK your Spouse to SIGN AN “Acceptance of Service” form
(Available at the Law Library Resource Center). This “Acceptance of
Service” form is your PROOF of NOTICE.
• NOTARIZE: Take your Spouse and the completed, “Acceptance of
Service” form to a Notary and have your Spouse SIGN the FORM
before the Notary.
• TAKE the NOTARIZED “MARITAL WAIVER” form to the hearing.
© Superior Court of Arizona in Maricopa County CVNCA10p - 051517
ALL RIGHTS RESERVED Page 3 of 5
Option (b) CERTIFIED MAIL DELIVERY: MUST BE DONE AT LEAST 30 DAYS
BEFORE THE HEARING:
• MAIL by CERTIFED RETURN RECEIPT the following to your Spouse:
(1) date stamped copy of your Application, and (1) Notice of Hearing
which states the date, time, and place of the hearing.
• Your PROOF of Notice for this “MAIL” step is the postcard you receive in
the mail showing delivery.
• Fill Out the “Affidavit of Service” form in this packet.
• NOTARIZE: Take the completed, “Affidavit of Service” form to a Notary
and SIGN the FORM before the Notary.
• TAKE (1) NOTARIZED “Affidavit” form and (1) Returned Postcard to
the hearing.
C. IF YOU DO NOT KNOW WHERE YOUR SPOUSE LIVES: NOTICE BY PUBLICATION:
The Court will not accept NOTICE by Publication unless diligent efforts have been made
to locate the person for whom NOTICE is required. For more information about Service
by Publication, please see the Law Library Resource Center Packet on “Service of Court
Papers When you Cannot Find the Other Party.”
(1) If Spouse’s last known address is in Maricopa County or a state OTHER THAN
ARIZONA:
• OBTAIN an “Affidavit of Service” from the Law Library Resource Center.
• Take your completed Notice of Hearing to a newspaper of general circulation in
Maricopa County.
• Give the Classified Advertising Staff your Notice of Hearing.
• ASK the newspaper staff to PUBLISH a LEGAL NOTICE (Classified advertisement
showing the date, time and place of your hearing) ONCE A WEEK FOR four (4)
CONSECUTIVE WEEKS before the hearing.
(2) If Spouse’s last known address is in an Arizona County OTHER THAN MARICOPA
COUNTY: You must publish NOTICE in TWO (2) Newspapers.
• OBTAIN an “Affidavit of Service” from the Law Library Resource Center.
• Take your completed Notice of Hearing to BOTH a newspaper of general circulation
in Maricopa County AND a newspaper of general circulation in the County of
the Spouse’s last known address.
• Give the Classified Advertising Staff your Notice of Hearing.
• ASK the newspaper staff to PUBLISH a LEGAL NOTICE (Classified
advertisement showing the date, time and place of your hearing) ONCE A WEEK
FOR four (4) CONSECUTIVE WEEKS before the hearing.
AFTER PUBLICATION ONCE A WEEK FOR 4 CONSECUTIVE WEEKS:
• OBTAIN an AFFIDAVIT OF PUBLICATION from the Law Library Resource Center.
• GO to the NEWPAPER where the NOTICE was published.
• REQUEST newspaper staff to COMPLETE THE AFFIDAVIT of PUBLICATION
• TAKE the Affidavit of Publication to the Clerk of Court where you filed the name
Change Application
• FILE the AFFIDAVIT of PUBLICATION with the Clerk of Court.
© Superior Court of Arizona in Maricopa County CVNCA10p - 051517
ALL RIGHTS RESERVED Page 4 of 5
STEP 9: ATTEND THE HEARING. Adults who request a name change MUST attend the hearing.
PLEASE BRING ALL OF THE FOLLOWING TO THE HEARING:
• BRING TWO (2) COPIES of the “ORDER CHANGING NAME FOR AN ADULT” to the
hearing for the Judge to sign. (One copy will be kept in the Court file, and the other copy of
the ORDER will be prepared for certification and then returned to you.)
• Be prepared to pay a FEE ($) for each certified copy of the ORDER.
• BRING PHOTO IDENTIFICATION of the person requesting a name change to the hearing.
Government-issued photo identification, such as a drivers’ license is acceptable.
• BRING A COPY of your original BIRTH CERTIFICATE.
• BRING A date stamped copy of ALL of your FILED DOCUMENTS.
• BRING PROOF OF NOTICE (As described in Step 8).
• BRING A COPY OF YOUR DIVORCE DECREE (If Applicable).
• BRING A COPY OF prior NAME CHANGE ORDERS (If Applicable).
• BRING PROOF of NATURALIZATION or RESIDENT ALIEN STATUS (If Applicable).
• BRING A COPY of ORDERS OF PROTECTION and/or INJUNCTIONS AGAINST
HARASSMENT still in effect (if Applicable).
• IF YOU ARE NOT A UNITED STATES CITIZEN and are requesting this name change,
BRING your PASSPORT OR PROOF OF IMMIGRATION STATUS.
HELPFUL NOTES about ATTENDING the HEARING
1. You must have all of the above documents for the Court to consider your Application.
2. The Court will not issue a Birth Certificate Change unless you bring a copy of your
original Birth certificate to the HEARING.
3. Hospital-issued birth certificates ceremonial and generally will NOT satisfy Court
requirements.
4. ALWAYS COPY any DOCUMENTS you give to the Court, and keep one copy for your
records.
5. The Judicial Clerk will give you a Judge signed copy of the court order if the Judge orders
a name change.
STEP 10: AFTER THE HEARING. If the Judge orders a name change to your Birth Certificate:
• GET CERTIFIED COURT ORDER: Within 48 hours of the hearing, TAKE THE Judge-signed
Court ORDER to the Court CLERK.
• PAY the FEE ($) to get your ORDER CERTIFIED by the CLERK.
• If more than 48 hours after the hearing has passed, you must go to the Clerk of Court
Customer Service Center at 601 West Jackson Street in Phoenix to get a CERTIFIED
ORDER.
• If you want the State Office of Vital Records to issue you a Birth Certificate with your
CHANGED NAME, you must provide Vital Records with a Certified Copy of the Court
Order Changing your Name.
• The State Vital Records Office at 1818 W. Adams, Phoenix, AZ. 85007, is only available for
mail-in service. Vital Records general telephone number is 602-364-1300. Please call for
another walk-in location. A fee is required for a change to any birth certificate.
© Superior Court of Arizona in Maricopa County CVNCA10p - 051517
ALL RIGHTS RESERVED Page 5 of 5
©Superior Court of Arizona in Maricopa County Page 1 of 3 CV10f 120120
ALL RIGHTS RESERVED
In the Superior Court of the State of Arizona
In and For the County of ___________________
Case Number ________________________________
CIVIL COVER SHEET- NEW FILING ONLY
(Please Type or Print)
Plaintiff’s Attorney __________________________
Attorney Bar Number _____________________
_____________________________________________
Is Interpreter Needed? Yes No
If yes, what language(s):
__________________________________
__________________________________
Plaintiff’s Name(s): (List all) Plaintiff’s Address: Phone #: Email Address:
(List additional Plaintiffs on page two and/or attach a separate sheet).
Defendant’s Name(s): (List All)
(List additional Defendants on page two and/or attach a separate sheet)
RULE 26.2 DISCOVERY TIER OR MONETARY RELIEF CLAIMED:
IMPORTANT: Any case category that has an asterisk (*) MUST have a dollar amount claimed
or Tier selected. State the monetary amount in controversy or place an “X” next to the discovery tier
to which the pleadings allege the case would belong under Rule 26.2.
Amount Claimed $_______________ Tier 1 Tier 2 Tier 3
NATURE OF ACTION
Place an “X” next to the one case category that most accurately describes your primary case. Any
case category that has an asterisk (*) MUST have a dollar amount claimed or Tier selected as
indicated above.
100 TORT MOTOR VEHICLE:
101 Non-Death/Personal Injury*
102 Property Damage*
103 Wrongful Death*
110 TORT NON-MOTOR VEHICLE:
111 Negligence*
112 Product Liability – Asbestos*
112 Product Liability – Tobacco*
112 Product Liability – Toxic/Other*
113 Intentional Tort*
114 Property Damage*
115 Legal Malpractice*
115 Malpractice – Other professional*
117 Premises Liability*
118 Slander/Libel/Defamation*
Case No.
_______________
© Superior Court of Arizona in Maricopa County Page 2 of 3 CV10f 120120
ALL RIGHTS RESERVED
116 Other (Specify) _______________*
120 MEDICAL MALPRACTICE:
121 Physician M.D.* 123 Hospital*
122 Physician D.O* 124 Other*
130 & 197 CONTRACTS:
131 Account (Open or Stated)*
132 Promissory Note*
133 Foreclosure*
138 Buyer-Plaintiff*
139 Fraud*
134 Other Contract (e.g, Breach of Contract)*
135 Excess Proceeds-Sale*
Construction Defects (Residential/Commercial)*
136 Six to Nineteen Structures*
137 Twenty or More Structures*
197 Credit Card Debt (Maricopa County Filings Only)*
145 & 150-199 OTHER CIVIL CASE TYPES:
156 Eminent Domain/Condemnation*
151 Eviction Actions (Forcible and Special Detainers)*
152 Change of Name
153 Transcript of Judgment
154 Foreign Judgment
158 Quiet Title*
160 Forfeiture*
175 Election Challenge
179 NCC-Employer Sanction Action (A.R.S. §23-212)*
180 Injunction against Workplace Harassment
181 Injunction against Harassment
182 Civil Penalty
186 Water Rights (Not General Stream Adjudication)*
187 Real Property *
145 Special Action against Lower Courts
(See lower court appeal cover sheet in Maricopa)
194 Immigration Enforcement Challenge
(A.R.S. §§1-501, 1-502, 11-1051)
144 & 150-199 UNCLASSIFIED CIVIL:
144 Administrative Review
(See Lower Court Appeal cover sheet in Maricopa)
150 Tax Appeal
(All other tax matters must be filed in the AZ Tax
Court)
155 Declaratory Judgment
157 Habeas Corpus
184 Landlord Tenant Dispute – Other*
190 Declaration of Factual Innocence (A.R.S. §12-771)
191 Declaration of Factual Improper Party Status
193 Vulnerable Adult (A.R.S. §46-451)*
165 Tribal Judgment
167 Structured Settlement (A.R.S. §12-2901)
169 Attorney Conservatorships (State Bar)
170 Unauthorized Practice of Law (State Bar)
171 Out-of-State Deposition for Foreign Jurisdiction
172 Secure Attendance of Prisoner
173 Assurance of Discontinuance
174 In-State Deposition for Foreign Jurisdiction
176 Eminent Domain– Light Rail Only*
177 Interpleader– Automobile Only*
178 Delayed Birth Certificate (A.R.S. §36-333.03)
183 Employment Dispute – Discrimination*
185 Employment Dispute – Other*
198 Verified Rule 27(a) Petition*
196 Verified Rule 45.2 Petition
195(a) Amendment of Marriage License (Maricopa
County Filings Only)
195(b) Amendment of Birth Certificate
163 Other* _________________________________
(Specify)
Case No.
_______________
© Superior Court of Arizona in Maricopa County Page 3 of 3 CV10f 120120
ALL RIGHTS RESERVED
EMERGENCY ORDER SOUGHT
Temporary Restraining Order Provisional Remedy OSC Election Challenge
Employer Sanction Other (Specify) ________________________________________________
COMMERCIAL COURT (Maricopa County Only)
This case is eligible for the Commercial Court under Rule 8.1, and Plaintiff requests assignment of this case to the
Commercial Court. More information on the Commercial Court, including the most recent forms, are available on the
Court’s website at: https://www.superiorcourt.maricopa.gov/commercial-court/.
Additional Plaintiff(s):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Additional Defendant(s):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Person Filing:
Address (if not protected):
City, State, Zip Code:
Telephone:
Email Address:
Lawyer’s Bar Number:
Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
In the Matter of:
Case Number: CV
APPLICATION FOR CHANGE OF
NAME FOR AN ADULT
Current Name of Applicant
(A.R.S. § 12-601)
INFORMATION ABOUT ME, THE APPLICANT
1. BIRTH NAME: on your original registered state Birth Record (Certificate):
First Middle Last
Date of Birth:
City of Birth:
County of Birth:
2. CURRENT LEGAL NAME:
First Middle Last
Current Address:
Current City of Residence:
Current State of Residence & Zip Code:
This is my married name, and that of my Current Spouse Past Spouse
For Clerk’s Use Only
© Superior Court of Arizona in Maricopa County CVNC11f - 060116
ALL RIGHTS RESERVED
Page 1 of 4
Case No. _________________
3. OT
HER NAMES: (Check all that Apply)
I was previously married –
o Fro
m
______________ to _______________ and used the following name:
(Month, Year) (Month, Year)
First Middle Last
I was previously married –
o Fro
m
______________ to _______________ and used the following name:
(Month, Year) (Month, Year)
First Middle Last
I changed my name – from this name:_________________________________
o When?
______________ to _______________ and used the following name:
(Month, Year) (Month, Year)
First Middle Last
I changed my name – from this name:_________________________________
o When?
______________ to _______________ and used the following name:
(Month, Year) (Month, Year)
First Middle Last
I have used the following alias:_________________________________
o When?
______________ to _______________ I used the following name:
(Month, Year) (Month, Year)
First Middle Last
I have used the following alias:_________________________________
o When?
______________ to _______________ I used the following name:
(Month, Year) (Month, Year)
First Middle
© Superior Court of Arizona in Maricopa County
Last
CVNC11f - 060116
ALL RIGHTS RESERVED
Page 2 of 4
Case No. _________________
REQUESTS TO THE COURT
1. I A
SK THAT MY NAME BE CHANGED TO:
First Middle Last
2. I ask that the birth records be ordered changed to reflect the new name requested above.
STATEMENTS TO THE COURT (REQUIRED BY ARIZONA LAW (A.R.S. § 12-601(C)))
Under Penalty of Perjury, I state the following as true:
(Check the boxes that indicate a true statement.) (For “4”, explain.)
1. I submit this application solely for the benefit and in the best interests of the person for
whom the name change is requested.
2. I understand and acknowledge that this change of name, if granted, will not release me
from any obligations incurred or harm any rights of property or action in any previous
name.
3. I am not knowingly requesting this change of name to that of another individual for the
purpose of committing or furthering any offense of theft, forgery, fraud, perjury,
organized crime or terrorism or any other offense involving false statements.
4. I request this name change because: (Explain)
5. Have you ever been convicted of a felony? Yes No
If “Yes,” all felony convictions are listed below.
Felony Case No. County & State Sentence
Date of
Conviction
1
2
3
4
5
Is there anything regarding your felony conviction(s) that you would like to bring to the Court’s
attention? (Optional)
© Superior Court of Arizona in Maricopa County CVNC11f - 060116
ALL RIGHTS RESERVED
Page 3 of 4
Case No. _________________
6. Are there any criminal charges (felony or misdemeanor) pending against you at this
time?
Yes No
If
“Yes,” all pending charges are listed below:
Pending Charges
Name of Court or City & State
Case No.
1
2
3
4
5
Is there anythi
ng regarding your pending criminal charges that you would like to bring to the Court’s
attention? (Optional)
UNDER OATH OR BY AFFIRMATION
I swear or affirm under penalty of perjury that the contents of this document are true
and correct to the
best of my knowledge and belief.
Date
Petitioner’s Signature
Printed Name
STATE OF
COUNTY OF
Subscribed and sworn to or affirmed before me this: by
(date)
.
(notary seal) Deputy Clerk or Notary Public
© Superior Court of Arizona in Maricopa County CVNC11f - 060116
ALL RIGHTS RESERVED
Page 4 of 4
Person Filing:
Address (if not protected):
City, State, Zip Code:
Telephone:
Email Address:
Lawyer’s Bar Number:
Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
In the Matter of:
Case Number:
NOTICE OF HEARING REGARDING
APPLICATION FOR CHANGE OF NAME
Name(s) of person(s) requesting name change
READ THIS NOTICE CAREFULLY. An important court proceeding that affects your rights has been
scheduled. If you do not understand this Notice or the other court papers, contact an attorney for legal advice.
1. NOTICE: An application for Change of Name has been filed with the Court by the person(s) named above. A
hearing has been scheduled where the Court will consider whether to grant or deny the requested change. If you
wish to be heard on this issue, you must appear at the hearing at the date and time indicated below.
2. COURT HEARING. A court hearing has been scheduled to consider the Application as follows:
DATE: TIME:
BEFORE:
Commissioner
Commissioner
125 W. Washington Street
18380 North 40th Street
Courtroom
Courtroom
Phoenix, AZ 85003
Phoenix, AZ 85032
Commissioner
222 E. Javelina Avenue
Courtroom
Mesa, AZ 85210
Commissioner
Commissioner
101 W. Jefferson , ____ floor
201 W. Jefferson , ____ floor
Courtroom
Courtroom
Phoenix, AZ 85003
Phoenix, AZ 85003
DATED:
(Month/Day/Year) Applicant's Signature
For Clerk’s Use Only
© Superior Court of Arizona in Maricopa County CVNC18f 021616
ALL RIGHTS RESERVED Page 1 of 1 Use only most current version
NOH
Person Filing:
Address (if not protected):
City, State, Zip Code:
Telephone:
Email Address:
Lawyer’s Bar Number:
Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
In the Matter of:
Case Number:
MARITAL WAIVER OF NOTICE
(Person Requesting Name Change)
REQUIRED INFORMATION, UNDER OATH OR AFFIRMATION:
1. INFORMATION ABOUT ME (the spouse of the applicant):
Name:
Address:
Telephone:
Date of Birth:
Month Date Year
I am married to the Applicant (the person requesting the name change).
2. I waive notice of all further proceedings in this matter.
UNDER OATH OR BY AFFIRMATION
I swear or affirm under penalty of perjury that the contents of this document are true and
correct to the best of my knowledge and belief.
Date
Spouse’s Signature
STATE OF
COUNTY OF
Subscribed and sworn to or affirmed before me this: by
(date)
.
(notary seal) Deputy Clerk or Notary Public
For Clerk’s Use Only
© Superior Court of Arizona in Maricopa County CVNC16f – 092917
ALL RIGHTS RESERVED Page 1 of 1 Use only most current version
Person Filing:
Address (if not protected):
City, State, Zip Code:
Telephone:
Email Address:
Lawyer’s Bar Number:
Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
Case Number:
Name of Applicant
AFFIDAVIT OF SERVICE
BY CERTIFIED MAIL
1. I am familiar with the facts stated in this Affidavit, and I make this Affidavit to show that I have served copies
of the “Application for Change of Name” and the “Notice of Hearing Regarding Application for Change
of Name” on the person named below by certified mail/restricted delivery, return receipt requested.
Person served (name of other party):
Address where other party was served:
Date of receipt by the other party:
2. The Application and Notice listed above were received by the other party as shown by the receipt, the original
of which is attached to this Affidavit on a separate piece of paper.
UNDER OATH OR BY AFFIRMATION
I swear or affirm under penalty of perjury that the contents of this document are true and correct to
the best of my knowledge and belief.
Date
Petitioner’s Signature
STATE OF
COUNTY OF
Subscribed and sworn to or affirmed before me this: by
(date)
.
(notary seal) Deputy Clerk or Notary Public
For Clerk’s Use Only
© Superior Court of Arizona in Maricopa County CVNC24f - 050115
ALL RIGHTS RESERVED Page 1 of 1 Use only most current version
AFM
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
In the Matter of:
Name of Applicant
Case Number:
ORDER CHANGING NAME OF AN ADULT
THE COURT FINDS:
1. This case has come before this Court
to change the current legal name of the Applicant.
to change the birth record of the Applicant
2. This Court has jurisdiction to change the legal name and/or the Birth Record of the Applicant.
3. Good cause exists to grant the application for change of name.
THE COURT ORDERS:
1.
The current legal name of the Applicant:
First Middle Last
Date of Birth:
Month Day Year
Place of Birth:
City State Nation
IS CHANGED TO:
First Middle Last
For Clerk’s Use Only
© Superior Court of Arizona in Maricopa County CVNC81f-021716
ALL RIGHTS RESERVED
ORD
Page 1 of 2
Case No. ____________________
The Birth record name of the Applicant:
First Middle Last
Date of Birth: _____________________________________________________
Month Day Year
Place of Birth:
City State Nation
IS CHANGED TO:
First Middle Last
2. For a person born in the State of Arizona, the Office of Vital Records is ordered to amend the birth
record to reflect the new name as above ordered.
For a person born in any other state, to the extent that the agency that maintains birth records in that
state is authorized to honor an order of this Court, that agency is requested or ordered to amend its
birth records to reflect the new name as above ordered.
3. This Order does not release the Applicant from any obligations incurred or harm any rights of property
or action in any original name.
4. Other orders:
DONE IN OPEN COURT: .
Date Judicial Officer
© Superior Court of Arizona in Maricopa County CVNC81f-021716
ALL RIGHTS RESERVED
ORD
Page 2 of 2
SUPERIOR COURT OF ARIZONA
IN MARICOPA COUNTY
In the Matter of:
Name of Applicant
Case Number:
ORDER CHANGING NAME OF AN ADULT
THE COURT FINDS:
1. This case has come before this Court
to change the current legal name of the Applicant.
to change the birth record of the Applicant
2. This Court has jurisdiction to change the legal name and/or the Birth Record of the Applicant.
3. Good cause exists to grant the application for change of name.
THE COURT ORDERS:
1.
The current legal name of the Applicant:
First Middle Last
Date of Birth:
Month Day Year
Place of Birth:
City State Nation
IS CHANGED TO:
First Middle Last
For Clerk’s Use Only
© Superior Court of Arizona in Maricopa County CVNC81f-021716
ALL RIGHTS RESERVED
ORD
Page 1 of 2
Case No. ____________________
The Birth record name of the Applicant:
First Middle Last
Date of Birth: _____________________________________________________
Month Day Year
Place of Birth:
City State Nation
IS CHANGED TO:
First Middle Last
2. For a person born in the State of Arizona, the Office of Vital Records is ordered to amend the birth
record to reflect the new name as above ordered.
For a person born in any other state, to the extent that the agency that maintains birth records in that
state is authorized to honor an order of this Court, that agency is requested or ordered to amend its
birth records to reflect the new name as above ordered.
3. This Order does not release the Applicant from any obligations incurred or harm any rights of property
or action in any original name.
4. Other orders:
DONE IN OPEN COURT: .
Date Judicial Officer
© Superior Court of Arizona in Maricopa County CVNC81f-021716
ALL RIGHTS RESERVED
ORD
Page 2 of 2
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NAME CHANGE (Maricopa County Telecommunications)

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Completed 3 May 2021

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