Petition for Name Change

The Utah Name Change Petition is a form that is used in the case of a legal name change. This form has to be submitted to the county court clerk’s office where you reside in the State of Utah along with the civil cover sheet. This form is submitted accompanied by a filing fee.

Extracted Text for Proper Search

Name Change:  Petition, p 1                                                                                          Approved:  November 19, 2004	  ____________________________ 
(Name) 
_____________________________  
(Address) 
_____________________________  
(City) 
_____________________________  
(Telephone) 
 
 
____________ DISTRICT COURT, ______________________ COUNTY, UTAH 
 
COURT’S ADDRESS:  _____________________________________________________ 
  	
 
 
IN THE MATTER OF THE   
NAME CHANGE OF: 
 
______________________________,	
  
 
PETITION FOR NAME CHANGE  
 	
(petitioner’s name) 
 
          Petitioner. 
 
  
Case No. ____________________ 
 
Judge  _______________________ 
       	
 
Petitioner states as follows: 
 
1. I  live in _________________________ County, as shown above, and have done so  
                   	
(name of county) 	
 for more than one year. 
 
2. My full and correct name is _____________________________. 
                                                   	
(your current legal name)	  
3. I ask the Court to change my name to ______________________________________. 
                                                                   	
(your proposed new name) 	
I want to change my name because ____________________________________ 
      	
(reasons for changing your name) 	 	
______________________________________________________________________________ 
______________________________________________________________________________

Name Change:  Petition, p 2                                                                                          Approved:  November 19, 2004	  4. I do not know any reason why I should not be allowed to change my name. 
5. Except for this petition, I am not presently involved in any court actions or 
proceedings.  
6.  I am not presently on probation or parole.   
  7.  I am not barred as a sex offender from obtaining a name change, under the provisions 
of Section 77-27-21.5(17).  I have attached a Certification Regarding Sex Offender Registry 
completed by Utah’s Department of Corrections, showing that there were no search results for 
my name. 
8.   I am not changing my name to avoid creditors or anyone else with a claim against me. 
9.  My name change will not affect any right, title or interest of anyone else, and I do  
not know anyone else who should be notified of this petition. 
 
DATED:  __________________________      ____________________________ 
Petitioner 
 
NOTARY CLAUSE 
________________________________, Petitioner, is personally known to me or presented  
satisfactory proof of identity to me. After being sworn and while under oath, Petitioner stated 
that he or she was acting voluntarily, had read and understood the preceding document, and that 
the contents were true. Petitioner then signed the document in my presence. 
 
Signed on _________________, 20____.    X_________________________________________ 
      Notary Public/Court Clerk 
 
 
          	
(Notary Seal)