Fillable ORDR Self-Represented Petitioner DISTRICT COURT CLARK COUNTY, NEVADA (Family Law Self Help Center)

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ORDR Self-Represented Petitioner DISTRICT COURT CLARK COUNTY, NEVADA (Family Law Self Help Center)

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© 2017 Family Law Self-Help Center Order for Adult Name Change
1
ORDR
Your Name: ________________________
Address: ___________________________
City, State, Zip: _____________________
Phone: ____________________________
Email: ____________________________
Self-Represented Petitioner
DISTRICT COURT
CLARK COUNTY, NEVADA
In the Matter of the Application of:
_
__________________________________
(print the old name you do not want anymore)
For Change of Name.
CASE NO.: ____________________
DEPT: _____________________
ORDER FOR CHANGE OF NAME
This Order was submitted (☒ check one) after a hearing without a hearing before
the above-entitled court, and after a review of the pleadings and papers on file and the testimony
given, if any, and good cause appearing therefore:
IT IS ORDERED that the name of the Petitioner, who was born on (date of birth)
_____________________ in (city) _______________________ (state) ____________________
be legally changed from
(old) _____________________ ______________________ _______________________
(first) (middle) (last)
To (new) _____________________ ______________________ ______________________
(first) (middle) (last)
A new birth certificate (☒ check one) shall shall not be issued.
DATED this ______ day of ______________, 20____.
____________________________________
DISTRICT COURT JUDGE
Submitted By: (your signature) _______________________________
(print your name) _______________________________
/s/
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ORDR Self-Represented Petitioner DISTRICT COURT CLARK COUNTY, NEVADA (Family Law Self Help Center)

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Completed 9 February 2021

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