Kansas Order Changing Name Form

In order to legally change your name in the State of Kansas, the following form has to be completed and submitted.

Extracted Text for Proper Search

IN THE                           	 JUDICIAL DISTRICT
DISTRICT COURT OF                                                    	
 COUNTY, KANSAS
IN THE MATTER OF THE PETITION OF
                                                                            
Case No. _____________	
Present Name	
Div. No. ______________
To Change His/Her Name to:
                                                                            	
  New Name	
PURSUANT TO K.S.A. CHAPTER 60
ORDER CHANGING NAME	
Pursuant to K.S.A. 60-1402
NOW, on this _____ day of _______________, 20_____, the above-captioned matter 
comes before the Court upon the Petition of ________________________________, for change
of his/her name. Petitioner appears in person. There are no other appearances. 
The Court, after review of the record of the proceedings herein, approves service or
waives any requirement for notice and determines the matter may proceed to hearing. 
The Court, upon hearing the testimony, upon examining the evidence presented, and
upon review of the record of the proceedings herein, finds as follows: 
1.  The Court has jurisdiction over the parties and the subject matter in this case. 
2.  Venue is appropriate in _______________________ County, Kansas. 
3.  Service has been properly obtained on, or notice has been given to, all interested
parties, or service and notice have been waived because there are no interested parties other than
petitioner. 
4.  The allegations contained in Petitioner’s Petition are true. 	
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5.  Petitioner, __________________________________, is now and has been a resident
of Kansas, for a period of more than sixty (60) days immediately preceding the filing of the
Petition. 
6.  Petitioner’s YEAR of birth is                	
 and petitioner’s place of birth is ___________
_______________________ County in the State of___________________________.
7.  Petitioner’s birth certificate shows his/her name as ____________________________
_____________________________________________________________________________.
8.  Petitioner’s present name is: _____________________________________________.
9.  Petitioner seeks to change his/her name to __________________________________
because _______________________________________________________________________
_____________________________________________________________________________. 
10.  The Petition for Change of Name is not made for the purpose of avoiding any debts,
obligations or legal process nor is it made for the purpose of misleading or defrauding any
person. The requested name change will not result in prejudice to any person. 
11.  No objections have been made to the Court and the Court finds Petitioner is entitled
to have his/her name changed from ______________________________________________ to:
_______________________________________________________. 
IT IS THEREFORE BY THE COURT CONSIDERED, ORDERED, ADJUDGED,
AND DECREED that the above and foregoing findings are made as orders of this Court, that	
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Petitioner’s name be changed to _______________________________________________, and
that the costs of this proceeding are assessed against Petitioner. 
IT IS FURTHER ORDERED that, upon proper application, an amended or substitute
birth certificate be issued to reflect Petitioner’s new name. 
IT IS SO ORDERED this _____ day of ________________, 20____.
____________________________________
Judge of the District Court 
SUBMITTED BY: 
________________________________________ 
Petitioner, Pro Se
Name (Print):_____________________________
Address 1: _______________________________
Address 2: _______________________________
City, State, Zip: ___________________________
Telephone Number: ________________________
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