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

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

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© 2017 Family Law Self-Help Center Summary Dispo. - Child’s Name Change
1
RSD
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: _____________________
REQUEST FOR SUMMARY DISPOSITION OF PETITION FOR CHANGE OF NAME
AND DECLARATION IN SUPPORT
Petitioner(s), (first parent’s name) ________________________________________ and
(second parent’s name, or “n/a”) _______________________________________ request this
Court for a summary disposition for a change of name(s) without a hearing.
Date: ____________________________ Date: ____________________________
________________________________ ________________________________
(First Parent’s signature) (Second Parent’s signature)
________________________________ _________________________________
(First Parent’s printed name) (Second Parent’s printed name)
Page 2 of 2 – Request for Summary Disposition - Child’s Name Change
DECLARATION OF PETITIONER
Petitioner(s) respectfully states as follows:
1. I/We am/are the Petitioner(s) in this case. I/We first moved to Clark County, Nevada on
(date) __________________, and intend to live in Clark County, Nevada indefinitely.
The child(ren) in this case are residents of Clark County, Nevada.
2. I/We live at (street address) _______________________________________________,
(city) ________________________, Nevada, (zip code) ______________.
3. I/We have read the Petition for Change of Name in this case and can testify that the
allegations are true and correct to the best of my knowledge.
4. I/We request (child’s current name) ________________________________________’s
name be changed to (child’s new name) ______________________________________
and (child’s current name or “N/A”) _______________________________________’s
name be changed to (child’s new name) ______________________________________.
5. The proposed name change is in the best interest of the child(ren), and/or there is clear
and compelling evidence that the substantial welfare of the child necessitates a name
change.
6. The child(ren) have not been convicted of a felony.
I/We declare under penalty of perjury under the law of the State of Nevada that the
foregoing is true and correct.
Date: ____________________________ Date: ____________________________
________________________________ ________________________________
(First Parent’s signature) (Second Parent’s signature)
________________________________ _________________________________
(First Parent’s printed name) (Second Parent’s printed name)
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RSD Self-Represented DISTRICT COURT CLARK COUNTY, NEVADA (Family Law Self Help Center)

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Completed 9 February 2021

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