Fillable REQUEST FOR NAME CHANGE (MINOR CHILDREN) (Illinois)

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REQUEST FOR NAME CHANGE (MINOR CHILDREN) (Illinois)

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The REQUEST FOR NAME CHANGE (MINOR CHILDREN) (Illinois) form is 2 pages long and contains:

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  • 3 check-boxes
  • 24 other fields

Country of origin: US
File type: PDF

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This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Circuit Courts.
STATE OF ILLINOIS,
CIRCUIT COURT
COUNTY
REQUEST FOR NAME CHANGE
(MINOR CHILDREN)
For Court Use Only
Instructions
REQUEST OF:
First, Middle, Last Name
TO CHANGE NAMES OF MINOR CHILDREN
Directly above, enter
the county name
where you will file
this case.
Case Number
Enter the name of the
person asking the
court to change the
names of minor
children.
DO NOT enter a Case
Number, the Circuit
Clerk will add it.
I ask the court to enter orders to change the names of the minor children listed below, and
state:
1.
Names.
Current Name of Minor Child
Proposed New Name of Minor Child
a.
b.
c.
d.
I am requesting name changes for more than 4 children. I have attached a Request for
Name Change – Additional Children form.
2.
I have attached a Request for Name Change - Child Information form for each child.
Yes
No
3.
I have lived continuously in Illinois for at least 6 months. I started living in Illinois on:
Date
In 1, enter the current
first, middle, and last
name of the children
and the new first,
middle, and last name
that you would like
for the children.
In 1, if you have more
than 4 children, list
additional children on
the Request for Name
Change - Additional
Children form and
check the box.
In 2, complete a
Request for Name
Change - Child
Information form for
each child and attach
it to this Request for
Name Change (Minor
Children).
In 3, enter the date
you started living in
Illinois. You must
have lived in Illinois
for 6 months before
you can file this
Request.
NCM-R 2003.3
Page 1 of 2
(01/19)
Enter the Case Number given by the Circuit Clerk: ____________________
Under the Code of
Civil Procedure, 735
ILCS 5/1-109, making
a statement on this
form that you know to
be false is a Class 3
Felony.
I certify that everything stated on the Request for Name Change (Minor Children) and on
the attached Request for Name Change - Child Information form is true and correct to
the best of my knowledge. I understand that making a false statement on this form is
perjury and has penalties provided by law under 735 ILCS 5/1-109.
/s/
If you are completing
this form on a
Your Signature
Street Address
computer, sign your
name by typing it. If
you are completing it
Print or Type Name
City, State, Zip
by hand, sign and
print your name.
Telephone
Enter your complete
current address and
I am using an alternative address because disclosing my address would put would put the
telephone number. If
child or a member of the household at risk.
disclosing the child's
address would put the
child or a member of
the household at risk,
you may use another
address. That address
must be one at which
you can receive mail
about the case.
GETTING COURT DOCUMENTS BY EMAIL: If you agree to receive court documents by email, check the box below and enter your email
address. You should use an email account that you do not share with anyone else and that you check every day. If you do not check your email
every day, you may miss important information or notice of court dates. Other parties may still send you court documents by mail.
NOTE
This section must be
filled out by someone
else, not by you.
Witness: Enter your
full name.
Under the Code of
Civil Procedure, 735
ILCS 5/1-109, making
a statement on this
form that you know to
be false is a Class 3
Felony.
Witness: Sign and
print your name.
Witness: Enter your
complete address and
telephone number.
I agree to receive court documents at this email address during my entire case.
Email
VERIFICATION BY WITNESS
I,
First
Middle
Last
certify that what is stated on the Request for Name Change (Minor Children) and on the attached
Request for Name Change—Child Information form is true and correct to the best of my
knowledge and belief. I understand that making a false statement on this form is perjury and
has penalties provided by law under 735 ILCS 5/1-109.
Witness Signature
Street Address
Print or Type Name
City, State, Zip
Telephone
NCM-R 2003.3
Page 2 of 2
(01/19)
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REQUEST FOR NAME CHANGE (MINOR CHILDREN) (Illinois)

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Completed 20 January 2021

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