INSTRUCTIONS: PETITION FOR INDIVIDUAL MINOR’S CHANGE OF NAME

This form needs submitted along with the Consent form if the minor is 14 years of age and older. You can find further instructions on what to do after completing this form in the Name Change Instruction Form for New York.

“Petition for Individual Minor’s Change of Name Step 1”

Provide your county’s name in the caption of the form. Do not fill in the Index number because the Clerk of Court will fill in this section.

“Petition for Individual Minor’s Change of Name Step 2”

In the line below the caption, provide the new name of the minor including first, middle, and last.

“Petition for Individual Minor’s Change of Name Step 3”

Provide the petitioning parent’s of guardian’s full legal name on line 1. On line 2, state your relationship to the minor. State the minor’s current legal name on line 3 including first, middle, and last.

“Petition for Individual Minor’s Change of Name Step 4”

On line 4, provide the intended name change for the minor. In the next section, provide the minor’s age, date of birth, and place of birth. For the date of birth, include the month, day, and year. Provide the county and state for the minor’s place of birth.

“Petition for Individual Minor’s Change of Name Step 5”

Provide the minor’s current address on line 6. In section seven, check the appropriate box for each question. The petitioner needs to provide their initials in each column and provide explanations for each question checked “Yes.”

“Petition for Individual Minor’s Change of Name Step 6”

State whether or not you’ve attempted to change the minor’s name in this county or any other county in the past within section 8. Strike out the option that does not apply.

“Petition for Individual Minor’s Change of Name Step 7”

In section 9, state the reasons for the minor’s change of name. The petitioner then needs to sign and date the bottom of the form.

“Petition for Individual Minor’s Change of Name Step 8”

The Petition then needs verified and signed in front of Notary Public.

“Petition for Individual Minor’s Change of Name Step 9”

If the minor was born in New York, the petition needs to attach a certified copy of a birth certificate, a Certified Transcript of the Birth Certificate, or a Certificate from the Commissioner.