Rev. 8/08 2008 Alabama State Bar
Request to Change Name
(For An Adult)
Case Number: (the clerk fills this in)
In the Probate Court of (county):
__________________________________________
first middle last
To ask the court to change your name, you must fill out this form, and:
• Attach a certified copy of your birth certificate and a copy of your photo ID, and
• File your form and attachments in the same county where you live.
I declare that the following information is true:
q My current name is:
first middle last
w My address is:
street city state zip
e My phone numbers are (home):
r My date of birth is (mm/dd/yyyy):
first middle last
y I am an adult (19 or older), of sound mind, and live in (name of Alabama county):
u The attached copy of my photo ID is my (check one): Driver’s license, #
Non-driver’s photo, ID #:
i I ask the court to change my name because (explain why you want to change your name):
o I want my new name to be:
first middle last
a I also declare:
• I am not now facing criminal charges, nor am I involved in any other court case.
• I have never been convicted of a criminal sex offense (as defined in Alabama Code § 15-20-21),
a crime of moral turpitude, or a felony.
• I am not asking to change my name to avoid paying my debts or to commit fraud.
• I swear that all of the information I have provided above is complete and accurate.
I ask the court to grant this request and to issue an order changing my name.
Sign below in front of a notary:
Notary fills out below—
Sworn to and subscribed before me, the undersigned authority,
By (Print name of notary):
Notary signs here Date notary’s commission expires
