Alaska Name Change Form

Case Type: CON IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT In the Matter of the Change of Name for: , Petitioner ...

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Case Type: CON

IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT In the Matter of the Change of Name for:

, Petitioner (current legal name)

) ) ) ) ) ) ) ) )

CASE NO.

CI

PETITION FOR CHANGE OF NAME

I, the petitioner, request the Court to enter judgment changing my name as follows: 1.

My current legal name is

2.

I want to take and be legally known by a new name, which is

3.

The reasons for this request for a change of name are:

4.

I seek this name change for personal reasons and not to avoid judgments, debts, obligations, or to defraud any person. The reasons stated are consistent with the public interest. VERIFICATION

I state on oath or affirm that I have read this document and believe all statements made in it are true. Date

Petitioner’s Signature Mailing Address

City

State

ZIP

Daytime Phone Subscribed and sworn to or affirmed before me at on . (date) (SEAL)

CIV-700 (9/02)(cs) PETITION FOR CHANGE OF NAME

, Alaska

Clerk of Court, Notary Public or other person Authorized to administer oaths. My commission expires Civil Rule 84 AS 09.55.010