© 2017 Family Law Self-Help Center Petition to Change Minor’s Name
* You are responsible for knowing the law about your case. For more information on the law, this form, and free
classes, visit www.familylawselfhelpcenter.org or the Family Law Self Help Center at 601 N. Pecos Road. To find
an attorney, call the State Bar of Nevada at (702) 382-0504.
1
PCON
Your Name:
Address:
Telephone:
Email Address:
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
In the Matter of the Application of:
__________________________________
(Parent’s name(s))
For Change of Name of the Minor Children:
__________________________________
(First child’s name)
__________________________________
and (Second child’s name or “N/A”)
CASE NO.: ____________________
DEPT: _____________________
PETITION TO CHANGE MINOR CHILD(REN)’S NAME
Petitioner(s) respectfully states as follows:
1. Petitioner is the parent of the child(ren) of the above-captioned petition.
2. Parents. The parents of the child(ren) are:
First Parent:
Name: ___________________________
Address: _________________________
City, State, Zip: ___________________
This parent agrees to the name change.
This parent will not agree to the name
change (you must explain why not on
the next page).
Second Parent:
Name: ___________________________
Address: _________________________
City, State, Zip: ___________________
This parent agrees to the name change.
This parent will not agree to the name
change (you must explain why not on
the next page).