Petition For Change Of Name Of Minor Child Ward

VIRGINIA FAIRFAX CIRCUIT COURT In the matter of the change of name of to PETITION FOR CHANGE OF NAME COMES NOW the petitioner(s) seeking a change of name for Virginia Code §8.01-217 and respectfully states under oath as follows: The child/ward currently resides in the County/City of The petitioner(s) desire a change of name for the following reasons: . This change of name is not sought for any fraudulent purpose and will not infringe on the rights of another. The name of the child/ward is The current address of the child/ward, including street, city and state of residence is . The child/ward's father is is The child/ward's date of birth is of the child/ward is , whose maiden name is and the child/ward's mother . , and the place of birth . . . child/ward pursuant to . Civil No. ______________ The child/ward has a felony conviction record, or is currently incarcerated or a probationer with any court, as follows: The child/ward has never had a change of name. Signature of Petitioner Daytime Phone No.____________ Signature of Petitioner Daytime Phone No.____________ *****If there are TWO petitioners, EACH Petitioner's Signature must be notarized.***** IN THE COMMONWEALTH OF VIRGINIA, COUNTY OF : I, the undersigned Deputy Clerk/Notary Public in and for the State of Virginia, do hereby certify that before me appeared , whose name(s) is/are signed to the foregoing Petition, and day of acknowledged the same under oath before me. Given under my hand and seal this . , Deputy Clerk/Notary Public CCR A-160 17-18 October 2006 My Commission expires: American LegalNet, Inc. www.FormsWorkflow.com VIRGINIA FAIRFAX CIRCUIT COURT In the matter of the change of name of to Civil No. ____________ ORDER This day came the petitioner(s), seeking to change the name of IT APPEARING to the Court that: The current address of the child/ward, including street, city and state of residence is _____________________________________________________________________________. The child/ward has never previously had a change of name. ADJUDGED, ORDERED and DECREED that the name of the child/ward is hereby changed from to , and further ADJUDGED, ORDERED, and DECREED that the Clerk of this Court, pursuant to the provisions of Virginia Code §8.01-217 shall spread this order upon the current deed book, index it in both the old and new names, and transmit a certified copy to both the State Registrar of Vital Statistics and the Criminal Records Exchange. Entered this day of , . minor child/ward. ____________________________________ JUDGE I ASK FOR THIS: ____ Signature of Petitioner Signature of Petitioner CCR A-160 17-18 October 2006 American LegalNet, Inc. www.FormsWorkflow.com