Fillable Please answer the questions below.

Fill Online, Printable, Fillable, Blank Please answer the questions below. Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Please answer the questions below.

On average this form takes 21 minutes to complete

The Please answer the questions below. form is 16 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 82 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Please answer the questions below.
When you answer the questions, they will automatically fill in that information where it belongs
on the following forms that you will be filing with the court. Do not leave any questions blank.
Any changes you make must be made to these questions; you will not be able to modify your
answers in the forms themselves.
1. What is the name of the County where you will be filing these forms?
________________________
2. What is your current full name?
____________________________________________________________
3. What is the full name you would like to change your name to?
____________________________________________________________
4. What is your mailing address?
____________________________________________________________
5. What is the town, state, and ZIP Code for your mailing address?
____________________________________________________________
6. If your street address where you live is a different address from your mailing address, what is your
street address?
____________________________________________________________
7. What is the town, state, and ZIP Code for your street address?
____________________________________________________________
8. What is your telephone number, with area code? ______________________
9. If you have a fax machine number and want to receive service by fax machine, what is your fax
machine number, with area code? ______________________
10. What is your date of birth? _____________________
11. What is your Indiana driver’s license number or Indiana identification number? _______________
12. Please list all of your previous names.
____________________________________________________________
SELECT ONE
13. If you have a valid passport, select “do”; if you do not have a valid passport, select “do not”. _____
14. If you have a valid passport, type “passport”; if you do not have a valid passport, what document do
you have as proof that you are a U. S. citizen? (Certified birth certificate, Consular report of birth abroad
or certification of birth, naturalization certificate, certificate of citizenship, or secondary documents. For
a list of secondary documents, please visit
https://travel.state.gov/content/passports/en/passports/information/citizenship-evidence.html
________________________________
15. List the judgments of felony convictions under the laws of any state or the United States that have
been entered against you. If you have had a felony conviction within ten (10) years, you must
provide notice of the filing of this Petition for Name Change to: (1) the sheriff of the county in
which you reside; (2) the prosecuting attorney of the county in which you reside; and (3) the
Indiana central repository for criminal history information. The notice given to the Indiana
central repository for criminal history information must include your full current name,
requested name change, date of birth, address, physical description, and a full set of classifiable
fingerprints. Failure to provide notice at least 30 days prior to the hearing on this Petition is a
Class A Misdemeanor.
______________________________________________________________________________
16. Why do you want to change your name?
______________________________________________________________________________
You have finished answering the questions. The following pages are the forms that you will be
printing and then filing with the court. Please look over them to make sure the information is
correct before you print them out. If you have changes, you must make them to the questions
above. You may also save a copy of this packet if you need to obtain more information before
answering the questions.
PLEASE NOTE: The court will set a hearing date when you file your Petition. Make sure this
date is filled in on the Notice of Petition for Change of Name. You will need to take this Notice
to the person who handles legal notices in your local newspaper. This Notice must appear
once a week for three weeks. The last publication must be at least 30 days before the hearing.
The newspaper will then send a proof of publication notice to you, which you will attach to the
Notice of Filing Proof of Publication and then file these forms with the court.
SELECT
Page 1 of 2 Form TCM-TR3.1-2
Revised by State Court Administration 10/10
STATE OF INDIANA ) IN THE CIRCUIT COURT
) SS:
COUNTY OF ) CASE NO.
IN RE THE NAME CHANGE OF: )
)
)
)
Petitioner. )
APPEARANCE BY SELF-REPRESENTED PERSON IN CIVIL CASE
This Appearance Form must be filed on behalf of every party in a civil case.
1. My Name is: ___________________________________ and I am
Initiating (filing) X ;
Responding (answering or defending)_____; or
Intervening ____;
in this case and am representing myself.
2. Contact information for receiving legal service of documents and case information is required by
Court Rules: (NOTE: If you are the Initiating party and this case, or a related case, involves a
protection from abuse order, a workplace violence restraining order, or a no-contact order, you must
provide an address for the purpose of legal service of documents but that address should not be one that
exposes the whereabouts of a petitioner)
Address: _____________________________________
_____________________________________________
Email Address: ________________________________
Phone: _______________________________________
FAX: ________________________________________
OR, if in the related case, you have used the Attorney General Confidential address, you may check the
box below:
____ Attorney General confidential address (contact the Attorney General at 1-800-321-1907 or
e-mail address is confidential@atg.state.in.us).
3. This is a __________ case type as defined in administrative Rule 8(B)(3).
(Clerk will supply this information.)
4. I will accept service by FAX at the following number _________________________
SELECT ONE
SELECT ONE
Page 2 of 2 Form TCM-TR3.1-2
Revised by State Court Administration 10/10
5. This case is a domestic relations matter, involves reciprocal enforcement of child support,
paternity, delinquency, Child in Need of Services (CHINS), guardianship, or any other proceedings in
which support may be an issue, and social security numbers of all family members are supplied on a
separately attached document (Form TCM-TR3.1-4) filed as confidential information on light green
paper.
______ Yes X No
6. There are related cases: Yes____ No X (If yes, please indicate below.)
Caption and case number of related cases:
Caption:____________________________ Case Number: ________________________
Caption:____________________________ Case Number: ________________________
Caption:____________________________ Case Number: ________________________
Caption:____________________________ Case Number: ________________________
Caption:____________________________ Case Number: ________________________
Caption:____________________________ Case Number: ________________________
7. Additional information required by local rule:
_________________________________________________________________________
____________________________________
Self-Represented Party
Page 1 of 2 Form PS-34282-1
Revised by State Court Administration 10/10
STATE OF INDIANA ) IN THE CIRCUIT COURT
) SS:
COUNTY OF ) CASE NO.
IN RE THE NAME CHANGE OF: )
)
)
)
Petitioner. )
VERIFIED PETITION FOR CHANGE OF NAME
Petitioner, ________________________________________________, pro se, respectfully petitions
this court to change his/her name. In support of this Petition, Petitioner states as follows:
1. That my current name is: ______________________________________.
2. That my date of birth is: _______________________________.
3. That my Indiana driver’s license number/Indiana identification card number is
______________________________; and I will bring my Indiana driver’s license or identification card
to my Change of Name Hearing for verification.
4. That my mailing address is: ________________________________________________
________________________________________________
And, if different, my residence address is: ________________________________________________
________________________________________________.
5. The following is a list of all of my previous names:
__________________________________________________________________________________.
6. That I ________ hold a valid United States passport. My proof that I am a United States
citizen is __________________________. I will bring this document to my Change of Name Hearing
for verification.
7. That the following judgments of criminal conviction of a felony under the laws of any
state or the United States have been entered against me, or I have stated immediately below that I have
no felony convictions:
__________________________________________________________________________________.
8. That I am not seeking to defraud creditors by changing my name.
9. That I have published notice of my request for name change in a local publication as
required by law, and will bring proof of publication to the hearing.
10. That I am not a sex or violent offender who is required to register under I.C. 11-8-8.
SELECT ONE
SELECT ONE
SELECT
Page 2 of 2 Form PS-34282-1
Revised by State Court Administration 10/10
11. That pursuant to Indiana Code 34-28-2-1, I wish to change my name. The reason I want
to change my name is:
__________________________________________________________________________________.
12. That I wish to change my name to___________________________________________.
WHEREFORE, I respectfully request that this Court grant my Petition for Name Change, and for
all other just and proper relief. I affirm under the penalties of perjury that the foregoing representations
are true.
______________________________
Signature
______________________________
Print your name
Page 1 of 1 Form PS-34282-2
Revised by State Court Administration 10/10
STATE OF INDIANA ) IN THE CIRCUIT COURT
) SS:
COUNTY OF ) CASE NO.
IN RE THE NAME CHANGE OF: )
)
)
)
Petitioner. )
NOTICE OF FILING PROOF OF PUBLICATION
Petitioner, ________________________________________________, pro se, states as follows:
1. I have given notice of my Petition for Change of Name, pursuant to Indiana Code 34-28-2-3(a).
2. I have attached a copy of the published notice herein as Exhibit A.
3. The attached notice has been verified by the affidavit of a disinterested person.
4. More than thirty (30) days have passed since the last required publication of notice.
WHEREFORE, I respectfully request that this Court consider my Petition for Name Change, and
for all other just and proper relief. I affirm under the penalties of perjury that the foregoing
representations are true to the best of my knowledge and belief.
_____________________________
Signature
SELECT ONE
Page 1 of 1 Form PS-34282-3
Revised by State Court Administration 10/10
STATE OF INDIANA ) IN THE CIRCUIT COURT
) SS:
COUNTY OF ) CASE NO.
IN RE THE NAME CHANGE OF: )
)
)
)
Petitioner. )
NOTICE OF PETITION FOR CHANGE OF NAME
________________________________________________, whose mailing address is:
________________________________________________
________________________________________________
And, if different, my residence address is:
________________________________________________
________________________________________________
__________________ County, Indiana hereby gives notice that she/he has filed a petition in the
__________________ Circuit Court requesting that his/her name be changed to
________________________________________________.
Notice is further given that hearing will be held on said Petition on the _______ day of
_____________________, 20____ at ________ o’clock ___m.
______________________________
Petitioner
Date __________________________
________________________________________
CIRCUIT COURT CLERK
SELECT ONE
SELECT ONE
SELECT ONE
SELECT ONE
SELECT ONE
Page 1 of 2 Form PS-34282-4
Approved by State Court Administration 10/10
STATE OF INDIANA ) IN THE CIRCUIT COURT
) SS:
COUNTY OF ) CASE NO.
IN RE THE NAME CHANGE OF: )
)
)
)
Petitioner. )
ORDER ON VERIFIED PETITION FOR CHANGE OF NAME
On ________________, Petitioner, _______________________________________________,
appeared for Change of Name Hearing. Witnesses sworn and evidence presented. Comes now the
Court, having reviewed the Verified Petition for Change of Name, Notice of Proof of Publication, and
the evidence presented at the hearing, and now finds as follows:
1. That Petitioner’s current name is: _________________________________________.
2. That Petitioner’s date of birth is: ______________________________.
3. That Petitioner’s Indiana driver’s license number/ Indiana identification card number was
filed with the Court and is preserved in the Court’s records.
4. That Petitioner’s mailing address is:
________________________________________________
________________________________________________
And, if different, Petitioner’s residence address is:
________________________________________________
_______________________________________________.
5. That Petitioner’s has no other previous names or Petitioner’s previous names are as
follows ___________________________________________________________________________.
6. That Petitioner does/does not hold a valid United States passport.
7. The Petitioner has presented proof of United States citizenship.
8. That the Petitioner has no felony convictions, or, the following judgments of criminal
conviction of a felony under the laws of any state or the United States have been entered against the
Petitioner: ___________________________________________________________________.
9. That Petitioner is not a sex or violent offender who is required to register under
I.C. 11-8-8.
10. That Petitioner has presented proof of publication of notice to the Court.
SELECT ONE
SELECT ONE
Page 2 of 2 Form PS-34282-4
Approved by State Court Administration 02/10
11. That pursuant to Indiana Code 34-28-2-1, Petitioner wishes to change his/her name.
12. That Petitioner wishes to change his/her name to be
_____________________________________________________.
13. That Petitioner is not seeking to defraud creditors by changing his/her name.
WHEREFORE IT IS ORDERED that Petitioner’s Petition for Change of Name is GRANTED,
and Petitioner’s name is hereby legally changed to __________________________________________.
SO ORDERED this _______ day of _____________________, 20____.
____________________________________
JUDGE
Distribution:
eForms
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Please answer the questions below.

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 11 October 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document