Petition for name change
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IN THE CIRCUIT COURT OF _Washington __ COUNTY, ARKANSAS 3rd DIVISION IN RE: __[YOUR CURRENT NAME]__ PETITION FOR CHANGE OF NAME The petitioner, __[YOUR CURRENT NAME]__, hereby states: 1. Petitioner is over the age of twenty-one (21) years and is a resident of _Washington_ County, Arkansas. 2. Petitioner wishes to change his/her name because: Petitioner is currently undergoing the process of a gender change. Petitioner has been diagnosed as a transsexual by a licensed psychologist, has been taking hormones to alter petitioner’s appearance to that of the intended gender, and plans to continue taking hormones and commence living the correct gender in order to qualify for surgical procedures. 3. Petitioner states and affirms that this request for a name change is not for the purpose of fraud, of violating any law, and is not/or will not, be detrimental to the interest of any other party. 4. The petitioner, by his/her own affidavit, submits to the court that upon first being duly sworn under oath before a Notary Public, all relevant facts as to why he/she desires a name change have been revealed herein. Therefore, he/she would like to be known henceforth as __[YOUR NEW NAME]__ .
Transcript of Petition for name change
IN THE CIRCUIT COURT OF _Washington__ COUNTY, ARKANSAS3rd DIVISION IN RE: __[YOUR CURRENT NAME]__ PETITION FOR CHANGE OF NAME The petitioner, __[YOUR CURRENT NAME]__, hereby states:1. Petitioner is over the age of twenty-one (21) years and is a resident of _Washington_ County, Arkansas.
2. Petitioner wishes to change his/her name because: Petitioner is currently undergoing the process of a gender change. Petitioner has been diagnosed as a transsexual by a licensed psychologist, has been taking hormones to alter petitioner’s appearance to that of the intended gender, and plans to continue taking hormones and commence living the correct gender in order to qualify for surgical procedures.
3. Petitioner states and affirms that this request for a name change is not for the purpose of fraud, of violating any law, and is not/or will not, be detrimental to the interest of any other party.
4. The petitioner, by his/her own affidavit, submits to the court that upon first being duly sworn under oath before a Notary Public, all relevant facts as to why he/she desires a name change have been revealed herein. Therefore, he/she would like to be known henceforth as __[YOUR NEW NAME]__. WHEREFORE, petitioner requests that this court allow his/her name to be legally changed from __[YOUR OLD NAME]__ to __[YOUR NEW NAME]__, and for this Court to order such a change in accordance with the laws of Arkansas. Respectfully submitted____________________________[YOUR OLD NAME], Petitioner
VERIFICATION STATE OF ARKANSAS ) ) ss.COUNTY OF Washington) On this _____day of ______________ , [YEAR], __[YOUR OLD NAME]__ personally appeared before me, a Notary Public for the above county, who stated that the statements contained in the foregoing Petition were true and correct to the best of his/her knowledge, information and belief. SUBSCRIBED AND SWORN TO before me this _____day of ______________, [YEAR]. __________________________Notary Public My Commission Expires: ____________________ ( S E A L )
