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Alaska Name Change Petition Form

To legally change one’s name in the State of the Alaska, interested individual must submit this form to the County Court Clerk’s office. A filing fee of $150.00 must also be paid by the applicant.

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CIV	-700 (2/1	3)(cs)	 	Civil Rule 84	 	
PETITION FOR CHANGE OF NAME	 	AS 09.55.010	 	
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA	 	
 	AT	  	 	
 	
In the Matter of the Change of Name for:	 	) 	
 	) 	
 	) 	
 	, 	) 	CASE NO.	 	CI	 	
Petitioner (current legal name)	 	) 	
Date of Birth	  	 	) 	
 	) 	PETITION FOR CHANGE OF NAME	 	
 	 	
I, the petitioner, request 	that 	the Court enter 	a jud	gment changing my name as follows:	 	
 
1. 	My current legal name is 	 	 	
 	First Name	 	Middle Name	 	Last Name	 	
 
2. 	I want to take and be legally known by a new name, which is	: 	
 	 	
First Name	 	Middle Name	 	Last Name	 	
 
3. 	The reasons for this request for a change of name are:	 	
 	 	
 	 	
 	 	
 	 	
 	
4. 	I ask  for	 this  name  change  for  personal  reasons  and  not  to  avoid  judgments,  debts, 	
obligations, or to defraud any person.  The reasons stated are consistent with the public 
interest.	 	
 	
VERIFICATION	 	
 	
I state on oath or affirm that I read this docum	ent and believe all statements in it are true.	 	
 
 	 	 	 	
 	Date	 	Petitioner’s Signature	 	
 	 	 	
 	Mailing Address	 	City	 	State	 	ZIP	 	
 	 	 	
 	Daytime Phone	 	Email Address	 	
 
Subscribed and sworn to or affirmed before me at	  	, Alaska	 	
on  	. 	
 	(Date)	 	
 
 	 	 	
(SEAL)	 	Clerk of Court, Notary Pu	blic or other person	 	
 	authorized to administer oaths.	 	
 	My commission expires
Next: Alabama Name Change Petition Form Previous: Arkansas Name Change Instructions Form
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