NAME CHANGE Self Help-Northampton County Court of Common Pleas
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1 NAME CHANGE Self Help-Northampton County Court of Common Pleas FORMS PACKET Name change in Pennsylvania is a judicial procedure which allows an individual to assume a name other than the name given at birth or adoption. If granted, the court will issue an order so the individual may prove the adoption of the new name in order to change other documents such as driver s licenses, bank accounts, and identification cards. This instructional section is for reference and research purposes. This section explains the basic forms and steps needed to legally change your name and/or the name(s of your minor child(ren. A person must petition the court for a name change, and the court can then decide whether or not to grant it.
2 IN THE COURT OF COMMON PLEAS OF NORTHAMPTON COUNTY, PENNSYLVANIA CIVIL DIVISION IN RE: CHANGE OF NAME DOCKET NO. PETITION FOR NAME CHANGE The petitioner(s,, requests that this Court order a change of name for and in support thereof represents as follows: 1. Petitioner(s is an adult individual, whose date of birth is and who currently resides at, in the County of Northampton. 2. Petitioner(s, also requests the court to change the names of, minor child, children whose date(s of is/are, and who is/are residing with the Petitioner at the above address. 3. Petitioner(s desires this change of name for the following reason(s: 4. Petitioner is a citizen of the United States of America.
3 5. There are no judgments or decrees pending against the Petitioner. 6. WHEREFORE, Petitioner respectfully requests that this Court enter an order changing the name of Petitioner from to. 7. WHEREFORE, Petitioner respectfully requests that this Court enter an Order changing the name of minor child/children from to. Respectfully submitted, Date Petitioner(s (Telephone Number
4 IN THE COURT OF COMMON PLEAS OF NORTHAMPTON COUNTY, PENNSYLVANIA IN RE: CHANGE OF NAME OF DOCKET NO. SCHEDULING ORDER AND NOW this day of, 2012, it is hereby Ordered that a hearing in the above-captioned name change matter is scheduled for: in Courtroom No., at Northampton County Courthouse, 669 Washington Street, Easton, PA, It is further ordered that a notice of said hearing shall be made by one (1 publication in both the Northampton County Reporter and in a newspaper of general circulation in Northampton County, PA. Such publication shall take place at least one (1 week prior to said hearing. Proof of publication shall be submitted prior to or at the hearing. BY THE COURT: J.
5 IN THE COURT OF COMMON PLEAS OF NORTHAMPTON COUNTY, PENNSYLVANIA CIVIL DIVISION IN RE: CHANGE OF NAME DOCKET NO. CONSENT FOR CHANGE OF NAME (MINOR CHILD(REN I, (full legal name being sworn, Certify that the following information is true: I am the birth or legal Father Mother of the minor child(ren in this case, and I give consent for the following name changes: Minor Child(ren s complete present name(s: Minor Child(ren s name s to be changed to I verify that the statements made in this Consent for name change of minor child(ren are true and correct. I understand that false statements are made subject to the penalties of 18 Pa.C.S relating to unsworn falsification to authorities. (Date (Signature of Consenting Parent (Address (Telephone
6 Sample Notice for Publication-Adult Name Change NOTICE NOTICE IS HEREBY GIVEN that on the 23 rd day of May, 2012, the Petition of John Doe was filed in Northampton County Court of Common Pleas at No C-0000, seeking to change the name of Petitioner from John Doe to John Smith. The Court has fixed Monday, July 9, 2012 at 9:00 a.m., in courtroom #4 at the Northampton County Courthouse as the date for hearing of the Petition. All persons interested in the proposed change of name may appear and show cause, if any they have, why the prayer of the Petitioner should not be granted.
7 Sample Notice for Publication-Minor Child(ren Name Change NOTICE NOTICE IS HEREBY GIVEN that on the 23 rd day of May, 2012, the Petition of John Doe was filed in Northampton County Court of Common Pleas at No C-0000, seeking to change the name(s of minor child(ren from Jane Doe to Jane Smith. The Court has fixed Monday, July 9, 2012 at 9:00 a.m., in courtroom #4 at the Northampton County Courthouse as the date for hearing of the Petition. All persons interested in the proposed change of name may appear and show cause, if any they have, why the prayer of the Petitioner should not be granted.
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