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Nevada Affidavit of Petitioner Form

The Nevada Affidavit of Petitioner is a form that has to be signed in front of a public notary and filed with the county clerk’s office in the State of Nevada.

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1 	AFPT 	
2 	
(yourname) 	______________________ 	__ 	
3 	
(Address) 	
4 
5 	
(Telephone) 	____________________ 	_ 	
6 	In Proper  Person 	
7 	DISTRICT 	COURT 	
8 
9 	
In the  Matter 	of 	the 	) 	
10 	
Application 	of: 	) 	CASE  NO: 	
) 	
11 	) 	DEPT. 	NO. 	
) 	
12 	for Change 	of 	Name 	) 
) 	
13 
14 	
AFFIDAVIT 	OF 	PETITIONER 	
15 	
STATE  OF 	NEVADA 	) 	
16 	
) ss: 	
COUNTY  OF 	) 	
17 
18 	1. 	I, 	(your name)  _______________________________ 	., 	Petitioner,  do solemnly 	
19 	swear  to testify  herein to the  truth,  the whole  truth and nothing  but the truth. 	
20 
21 
22 
23 
24 
25 	
That  I am  the  Petitioner  in the  above-entitled  case. 
That  I live  at 	
___________________________________ 	(city) 	
_______________________________ 	Nevada,  (zip code) 	___________ 	. 
That  I first  moved  to 
Nevada on (date) 	
___________________ 	. 	
It 	is 	my 	intention  to live  in  for the  foreseeable  future. 
5. 	That I have  read the Petition  for Change 	of 	Name  in this  case  and can testify  that 	
Clark County  Family Law  Self-Help Center 	
December 	10	, 2003 	
ALL  RIGHTS 	RESERVED 	
1 	
adultillamechan.5af 	(# 5) 	
Use 	only  most  current  version 
Please  call the Self-Help  Center to confirm 	
most 	current  version

1 	the allegations  in the  Petition  are true  and correct 	to 	the best 	of 	my 	knowledge. 	
2 	
6. 	That  I request  that the Court  change 	my 	name from 	___________ 	_ 	
3 	
________________________________ 	to 	__________________________________ 	. 	
4 	
7. 	That I have  not been  convicted 	of 	a felony. 	
5 	
8. 	That  I am  not  changing 	my 	name 	to 	avoid  creditors  or 	to 	commit a fraud. 	
6 	
Dated  this (day) 	_______ 	day 	of 	(month) 	___________ 	" 	(year) 	____ 	. 	
7 	
(Your  signature) 	___________________________ 	_ 	
8 
9 	
(Your name) 	
10 
11 	SUBSCRIBED 	and 	SWORN 	to before 
me  this 	
___ 	day 	of 	
12 	(month)  , (year) 	_____ 	. 	
23 	
II  I 	
24 	
II I 	
25 	II I 	
2 	
adultillamechan.5af 	(#	5) 	
Use 	only  most  current  version 
Please  call the Self-Help  Center to confirm  most current  version
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