© 2017 Family Law Self-Help Center Notice of Petition for Family Name Change
1
NOTC
Your Name: ________________________
Address: ___________________________
City, State, Zip: _____________________
Phone: ____________________________
Email: ____________________________
Self-Represented Petitioner
DISTRICT COURT
CLARK COUNTY, NEVADA
In the Matter of the Application of:
(1
st
adult) ________________________________
And
(2
nd
adult) ________________________________
write “n/a” above if only 1 adult.
For Change of Name for Themselves and for the
Minor Children:
(1
st
child’s name) ___________________________
And
(2
nd
child’s name) __________________________
CASE NO.: ____________________
DEPT: _____________________
NOTICE OF PETITION FOR CHANGE OF NAME
TO: (Name of any parent not filing a written consent):
(Other parent’s name is REQUIRED above if parent is not consenting to the name change)
NOTICE IS HEREBY GIVEN that a petition was filed in the above-entitled Court
requesting that the Court legally change applicant’s name from
(clearly print the old name the first adult does not want anymore)
_____________________ ______________________ _______________________
(first) (middle) (last)
to: (clearly print the name the first adult wants to be known by in the future)
_____________________ ______________________ _______________________
(first) (middle) (last)
