CAUSE NO. _______________________
IN THE MATTER OF IN THE _______________
THE MARRIAGE OF
____________________________________ DISTRICT COURT OF
_____________________________________ DALLAS COUNTY, TEXAS
AFFIDAVIT OF PARTY
REQUESTING NAME CHANGE
COUNTY OF DALLAS STATE OF TEXAS
BEFORE ME, the undersigned authority, on this day personally appeared
___________________________________________________, Petitioner in the above named and numbered cause,
who being by me duly sworn, on oath stated:
“My name is __________________________________________________. I am the Petitioner in the above named
and numbered cause.
I have personal knowledge of the facts stated in this affidavit, and they are true and correct.
I am a _______________________________________ _____________________________ adult.
My Social Security Number is _______________________________________________________.
I have been a resident of Dallas County since the filing of the Original Petition.
I have been issued a Texas Driver’s License Number: _____________________________________.
I have never been arrested or charged with a criminal offense.
The change of name requested is in my best interest and to my benefit and in the interest of the public.
The name requested, _________________________________________________, is the name I had before I
married the respondent.
I am not asking for the resumption of my former name in order to attempt to evade any legal obligation.
I want to resume the use of my former name because I (have children/have no children) with that name
and I have been married to ________________________________________________ for ____________ years.
I have demonstrated good cause for a name change.
Signed and Sworn to before me on the ___________ day of __________________________________, 20_______.
Notary Public, State of Texas