Iowa Name Change Petition Form

In the case of wanting to apply for a legal name change in the State of Iowa, the following form has to be completed and submitted.

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IN THE IOWA DISTRICT COURT FOR _________________________COUNTY	
                                                                        \�)
IN RE THE NAME CHANGE OF:	)    No. _________________________
)	
_________________________________	)     PETITION FOR CHANGE OF NAME
)                                (Adult)	
COMES NOW petitioner and for his/her petition under Iowa Code Chapter 67\�4,	
states:	
1.  Petitioner's present name is _______________________________________\�_____	
and she/he resides in _____________________________________ County, Iowa\�.	
2.  Petitioner is ___________ feet, ________ inches tall; weighs _______\�___ lbs.; has	
___________ color hair; and _______________ color eyes.	
3.  Petitioner is a __________________________(race) _____________(fe\�male/male)	
who was born in _____________________________ (place) on _____________\�_____ (date).	
4.  Petitioner owns the following real estate in Iowa (set out legal de\�scription):	
________________________________________________________________________\�___
________________________________________________________________________\�___	
5.  Petitioner currently resides at ____________________________________\�_______	
_______________________________________________________ and has resided \�at the
following addresses during the past five years: ________________________\�_____________
________________________________________________________________________\�___
________________________________________________________________________\�___
________________________________________________________________________\�___.	
6.  Petitioner is (check)       unmarried or      married.
7.  Petitioner desires a name change for the following reasons:  _______\�___________	
________________________________________________________________________\�___
________________________________________________________________________\�___.

8.  Petitioner has not previously requested a name change pursuant to Io\�wa Code	
chapter 674.	
9.  A certified copy of petitioner's birth certificate is attached to th\�is petition.
WHEREFORE, petitioner prays that the court enter an order changing petit\�ioner's	
name from ______________________________________________________________\�___
to _____________________________________________________________________\�___ .
      ___________________________________	
Petitioner's Signature	
STATE OF IOWA, COUNTY OF ______________________________  ) ss.	
I, _________________________________________, being first duly sworn upo\�n	
oath, state that I am  the petitioner  in the  foregoing  petition; that I have  read and know  the
contents  of said  petition,  and that  the allegations  and statements  contained therein are true  and
correct.
      ___________________________________	
    Petitioner's Signature (observed by notary)	
Subscribed and sworn to before me this ______ day of _______________, 20\�____.
__________________________________
Notary Public in and for the State of Iowa