Petition for Change of Name of Minor

State of New Hampshire Court _____________________________

County of ________________ Docket No. ________________________

Name of Petitioner(s): In re: Change of Name of Minor

_____________________________ From: _____________________________
_____________________________ To: _______________________________

Petitioner(s) makes (make) the following declaration:

1. Birth Date and Place: The minor was born on _______________________, 20____ in
________________________ [city], ________________________ [county],
________________________ [state]. A certified copy of the minor's birth certificate is
attached to this petition.

2. Birth Name: The minor was named

____________________________________________ at birth, and as of the date of this
petition, the minor has always been known by that name, with the following exceptions, if any:
__________________________________________________________________________
___
__________________________________________________________________________
___
__________________________________________________________________________
___
[list all legal names previously held].

3. Residence: The minor resides at

__________________________________________________________________________
___ [insert the minor's residential address] and has lived at this address for ________ [insert
length of time in months or years at this address]. The Petitioner(s) resides (reside) at
__________________________________________________________________________
___ [insert residential address] and has (have) lived at this address for ________ [insert
length of time in months or years at this address].

4. Minor's Parents: The father of the minor is named

______________________________________________, and he resides at
__________________________________________________________________________
___ [insert residential address of father]. The mother of the minor is named
______________________________________________, and she resides at
__________________________________________________________________________
___ [insert residential address of mother].

5. Reason for Name Change: Petitioner(s) seeks (seek) to change said minor's name to
______________________________________________ and offers (offer) the following
reason(s) for seeking to do so:
__________________________________________________________________________
___
__________________________________________________________________________
___
__________________________________________________________________________
___.

6. Legal and Creditor Status: The minor does not have any outstanding judgments, has
never been convicted of a crime, and is not involved in any pending legal actions.

7. Additional Declarations: In addition to the foregoing statements, the Petitioner(s) further

declares (declare):
__________________________________________________________________________
___
__________________________________________________________________________
___
__________________________________________________________________________
___
[insert additional declarations, if any].

NOW, THEREFORE, the Petitioner(s) requests (request) that the court order the minor's
name changed as follows:

From: ____________________________________________
To: ______________________________________________

Verification (Petitioner #1)

I,
__________________________________________________________________________
___
__________________________________________________________________________
___ [name of Petitioner], affirm under penalty of perjury that I am the (a) Petitioner in the
foregoing Petition to Change Name of Minor and that all statements in this Petition are
accurate to the best of my knowledge.

_____________________________________________ _________________
Petitioner's Signature Date

_____________________________________________
Petitioner's Address, Line 1

_____________________________________________
Petitioner's Address, Line 2

Verification (Petitioner #2, if any)

I,
__________________________________________________________________________
___
__________________________________________________________________________
___ [name of Petitioner], affirm under penalty of perjury that I am the (a) Petitioner in the
foregoing Petition to Change Name of Minor and that all statements in this Petition are
accurate to the best of my knowledge.

_____________________________________________ _________________
Petitioner's Signature Date

_____________________________________________
Petitioner's Address, Line 1

_____________________________________________
Petitioner's Address, Line 2
Subscribed and sworn to before me on this ____ day of __________________, 20_____.

__________________________________
Notary

- - - - Consent to Change of Name of Minor Form - - - -

(Note: The grey box below is not a part of the Petition and is included for informational purposes only. You should not include
the grey box as part of this document.)

About this Consent to Change of Name of Minor Form: The following consent form may
accompany the Petition for Change of Name of Minor if needed. Contact the court clerk in the
county in which the minor resides to determine whether this consent is required.

Consent to Change of Name of Minor

State of New Hampshire Court _____________________________

County of ________________ Docket No. ________________________

Name of Petitioner(s): In re: Change of Name of Minor

_____________________________ From: _____________________________
_____________________________ To: _______________________________

I make the following declaration:

1. Name: My name is ____________________________________________, and as of the

date of the signing of this Consent, I have always been known by that name, with the
following exceptions, if any:
__________________________________________________________________________
___
__________________________________________________________________________
___
__________________________________________________________________________
___

2. Residence: I reside at
__________________________________________________________________________
___ [insert the residential address] and have lived at this address for ________ [insert length
of time in months or years at this address].

3. Consent to Change of Name of Minor: I am fully informed of the legal consequences

and effects, and I give my consent to the request of the Petitioner(s) to change the name of
said minor child as follows:

From: ____________________________________________
To: ______________________________________________

Verification

I,
__________________________________________________________________________
___
__________________________________________________________________________
___ [name of individual granting his or her consent], affirm under penalty of perjury that all
statements in this Consent to Change of Name of Minor are accurate to the best of my
knowledge.
_____________________________________________ _________________
Signature Date

_____________________________________________
Address, Line 1

_____________________________________________
Address, Line 2