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					NAME CHANGE

       ADULT




            N-1


The District Court Filing Office
 is located on the first floor at
     75 Court Street
    Reno, NV 89501
                                    ATTENTION


             THIS PACKET IS NOT A SUBSTITUTE FOR THE
                     ADVICE OF AN ATTORNEY


                                  IMPORTANT
 If either party is in the military, special rules may apply and it is recommended you
 seek the advice of an attorney.



                 Counsel Is Always Recommended For Legal Matters

The law allows any person to represent himself or herself in a legal action. However,
filing papers with the court and representing yourself in the courtroom can involve
complicated legal issues. This packet does not address all the legal issues involved in
bringing your matter before the court. This packet is created to help you access the legal
system without the assistance of an attorney.

When representing yourself, you are responsible for understanding the law that governs
your case and for filing the proper legal documents. The laws and rules are set out in the
Nevada Revised Statutes, The Rules of Civil Procedure, and the local rules governing the
jurisdiction in which you are filing your documents.

When you sign these documents and present them for filing with the court, it is assumed
by the court that you have carefully read the documents, that you understand all the terms
in the documents, that you agree with all the provisions in the documents, and that you
are aware of all the consequences those provisions may produce.

Before filling in any portion of the following documents, read all the materials
included in this packet including the definitions of terms.



THIS INFORMATION IS PROVIDED AS A COURTESY ONLY. THE COURT,
SELF-HELP CENTER, NON-PROFIT ORGANIZATION, OR LAW LIBRARY
THAT MAY PROVIDE THIS INFORMATION SHALL NOT BE LIABLE FOR
ERRORS CONTAINED HEREIN OR FOR DIRECT, INDIRECT, SPECIAL OR
CONSEQUENTIAL DAMAGES IN CONNECTION WITH THE FURNISHING
OF THIS MATERIAL.




REV 7/2010 AA
                                   NAME CHANGE - ADULT
                                       PACKET N-1


                       INSTRUCTIONS FOR FILLING OUT FORMS

               CAREFULLY READ THROUGH ALL OF THE INSTRUCTIONS BEFORE
                       STARTING TO FILL OUT ANY OF THE FORMS.

                               Use black ink only to fill out the forms and neatly
                                       print the information requested.

                  Do not use Wite-Out or other correction fluid/tape on the forms.
        They will not be accepted by the Filing Clerk’s Office if correction fluid/tape is used.


Included in this packet are the following documents:

          1.          Civil Cover Sheet

          2.          Petition for Legal Change of Name

          3.          Notice

          4.          Proof of Publication

          5.          Request for Submission

          6.          Order Changing Name




  The penalty for making a false statement in a declaration that is made under penalty of
  perjury is a minimum of 1 year and a maximum of 4 years in prison, with the possibility
  of an additional fine of $5000 or more if authorized or required by statue. See N.R.S.
  §199.145




                                                       1
REVISED 8/9/2010 AA                                                                  N1 INSTRUCTIONS
                              FILLING OUT THE DOCUMENTS

                                      The Civil Cover Sheet

Starting at the top, leave the Case No. blank. When you file the documents with the filing clerk, a
case number and a department number will be assigned.

In Paragraph I – Party Information – fill in your name, physical address (and mailing address, if
different from physical address) and telephone number.

In Paragraph II – Nature of Controversy – under “Other Civil Filing Types,” check “Name Change
– NC.”

Fill in the date, print and sign your name.


                               Petition for Legal Change of Name

In the upper left corner print your name, address and telephone number.

In the heading portion of the Petition, print your present name. Leave the Case No. and Dept. No.
blank. The Filing Clerk’s Office will fill in that information when you file the documents.

Complete the form, carefully following the instructions listed on the form itself.


                                               Notice

In the upper left corner print your name, address and telephone number.

In the heading, print your present name. Leave the Case No. and Dept. No. blank. The Filing
Clerk’s Office will fill in that information when you file the documents.

Carefully fill in the rest of the information as it is requested in the document.

DO NOT fill in the date. The Filing Clerk will fill in the date and sign the Notice when you file the
documents.

  DO NOT fill in the rest of the forms at this point. The Proof of Publication,
  Request For Submission and Order Changing Name can be filled out once the
  publication of the Notice is completed.



                                                  2
REVISED 8/9/2010 AA                                                           N1 INSTRUCTIONS
                               Copying And Filing The Documents

Make one (1) copy of the Civil Cover Sheet, and the Petition for Legal Change of Name. Make two
(2) copies of the Notice.

Take the original and the copies to the filing clerk’s office, which is located on the first floor of the
courthouse located at 75 Court Street, Reno, NV. There will be a filing fee payable when you file
the documents. To confirm the amount of the filing fee, you may call the filing clerk’s office at
(775) 328-3110.


                                    FILING FEE WAIVERS

If you cannot afford the filing fee, you may apply to have your filing fee waived. To apply,
you must fill out and file the application found in the IFP (In Forma Pauperis) fee waiver
packet.

The IFP fee waiver packets may be obtained in the following location(s):

     •    Filing Clerk’s Office, 75 Court Street, Reno, NV
     •    Family Court Self Help Center, 1 South Sierra Street, Reno, NV



          The filing clerk will:
          1. Assign your case a case number and a department number and fill in that information on
             your documents;
          2. Sign the Notice form;
          3. Stamp the documents as “filed”;
          4. Keep the original documents; and
          5. Return the “file stamped” copies to you.

                                        Publishing the Notice

Take one copy of the file stamped Notice form to either the Sparks Tribune or the Reno Gazette
Journal for publication. The Notice must be published once a week for three consecutive weeks in
either newspaper.

At the end of the three week publication period, the newspaper will mail you an Affidavit and a copy
of the published Notice.

When you receive the Affidavit from the newspaper, the Proof of Publication form should be filled
out and filed with the Filing Clerk’s office.

                                                   3
REVISED 8/9/2010 AA                                                             N1 INSTRUCTIONS
                                  Proof of Publication Form

In the upper left corner fill in your name, address and telephone number.
Fill in the heading as it appears on your other documents including the Case No. and Dept. No.
Date and sign the document and fill in your address and telephone number.

On the second page, titled Index of
Exhibits, write “1” (the number one)
next to the Exhibit Number.

Fill in the number of pages of your
Proof of Publication.

Write “Proof of Publication” next to
the Exhibit Description.

* If you have more than one “Proof of
Publication,” follow the instructions
above making sure to list all of your
exhibits in numerical order
(1…2…3…etc.)




On the third page, also called the
exhibit cover page, write “1” (the
number one) as the Exhibit Number.

Attach your “Proof of Publication”
from the newspaper behind this
exhibit cover page.

*If you have more than one “Proof of
Publication” make copies of this
exhibit cover page and follow the
instructions above, making sure to
number your Exhibits in numerical
order (1…2…3…etc.)


Make one (1) copy of your complete “Proof of Publication” form (including the “Proof of
Publication” form, the index of exhibit(s), the exhibit cover page(s) and the attached “Proof of
Publication” from the newspaper(s)).

                                               4
REVISED 8/9/2010 AA                                                       N1 INSTRUCTIONS
Take the original and the copy to the Filing Clerk’s office to file. The filing clerk will keep the
original, and return the “file stamped” copy to you.


                             The Request For Submission and Order

TEN DAYS following the last date of the publication of the notice in the newspaper, fill out the
Request for Submission and the Order form.

Request for Submission – fill in the heading on the document just as it appears on your other
documents including the Case No. and Dept. No. Complete the form. Date and sign the form.

Order Changing Name – fill in the heading on the document just as it appears on your other
documents including the Case No. and Dept. No.

Fill in the information as required on the Order. DO NOT date the end of the Order. The judge will
fill in the date when he/she signs the Order.


                                Copying And Filing The Documents

Make one (1) copy of the Request for Submission, three (3) copies of the Order. Take the originals
and the copies to the filing clerk’s office, which is located on the first floor of the courthouse located
at 75 Court Street, Reno, NV. File in your documents.

Since copies of the Order are usually needed for making any changes on legal documents such as
your Social Security card, your Driver’s License, etc., it is suggested that you get at least three (3)
certified copies of the Order from the Filing Clerk’s Office.

If you include a self-addressed, stamped envelope with your documents, the Court will mail the
copies of the signed order to you when it is signed by the judge. You may follow up with the Court
regarding the progress of your case by calling the Filing Office at (775) 328-3110.



                        Common Misconceptions About A Name Change

When an order is issued changing a name, it does not automatically change your name on your
birth certificate. You must contact the Bureau of Vital Statistics in the State in which your birth
certificate was issued to find out what they need to modify your birth certificate. Usually they
will require a certified copy of the Order Changing Name.

It is possible that your original name will not be removed from your birth certificate. The
                                                    5
REVISED 8/9/2010 AA                                                              N1 INSTRUCTIONS
certificate may still show your original name with “formally known as” written on the certificate
with your new name typed above your old name.

Even with the Order, the Bureau of Vital Statistics will not automatically issue a new birth
certificate. It is up to you to find out what the Bureau of Vital statistics in the State in which
your certificate was issued needs in order to re-issue a certificate.




                                                6
REVISED 8/9/2010 AA                                                         N1 INSTRUCTIONS
                       AFFIRMATION PAGE INSTRUCTIONS

Every document filed with the Court must contain written Affirmation stating whether or not the
document has a social security number written in it. These instructions are included for
documents that have a separate Affirmation page. Not all documents have a separate
Affirmation page.

At the top of the attached Affirmation page, there are two lines where you are to write the name
of the document that is attached to the Affirmation page. There are two lines because some
documents’ titles are very long. The names of most documents are found in the middle of the
page, in all capital letters and underlined.

Some Family Court documents have their titles in different places. The “Civil (Family Related)
Cover Sheet” title is at the top, center of the page. The “Confidential Family Court Information
Sheet” title is at the top, right side of the page. The “Family Court Motion/Opposition Notice”
title is in a box on the top, right side of the page. So, check the top center and top right of your
documents for these titles.

The next line on the Affirmation page asks for the case number. If your case is not new, you
should have a case number. Write the case number in the blank. If your case is new and does
not yet have a case number, do not write anything on that line.

Next, you will mark either the box next to the phrase that says the document “does not contain
the social security number of any person” or the box next to the phrase that says the document
“contains the social security number of a person . . . .”

In most Family Court cases, the only document that contains social security numbers in the
“Confidential Family Court Information Sheet.” For that document, you will mark the box that
says there are social security numbers in the document and the last box before the date and
signature lines, to indicate that the document contains social security numbers because it is the
“Confidential Family Court Information Sheet.”

If your document contains a social security number as required by some other law, select the box
next to the appropriate phrase. If a specific State or Federal law requires the document to
include a social security number, write the name of or cite of the applicable law on the line
provided.

Finally, write in the date, sign the signature line, and print your name on the lines that say
“Date,” “Signature,” and “Print Name.” Leave the “Attorney for” line blank.




                                                  7
REVISED 8/9/2010 AA                                                           N1 INSTRUCTIONS
                 IMPORTANT

                 BEFORE
                YOU START
         READ ALL INSTRUCTIONS
              CAREFULLY



          Do NOT use Wite-Out                    ®


      or other correction fluid/tape on the documents.
     The Filing Office will not accept documents with
     Wite-Out® or other correction fluid/tape on them.


                Use Black Ink
   PRINT all information neatly
REV 7/2010 AA
                                                          CIVIL COVER SHEET
                                                           Washoe County, Nevada
                                              Case No. ____________________________________
                                                            (Assigned by Clerk’s Office)
  I. Party Information
 Plaintiff(s)/Petitioner (name/address/phone):


 DOB:____________________________
 Attorney (name/address/phone):




II. Nature of Controversy (Please check applicable bold category and                                           Arbitration Requested
applicable subcategory, if appropriate)
                                                                 Civil Cases
                 Real Property                                                                Torts
     Landlord/Tenant - LT
                                                                 Negligence                           Product Liability
                                                       Negligence – Auto - VP                            Product Liability/Motor Vehicle-VH
          Unlawful Detainer - UD
                                                       Negligence – Medical/Dental - MD                  Other Torts/Product Liability - PL
     Title to Property
          Foreclosure - FC                             Negligence – Premises Liability -SF            Intentional Misconduct
                                                                                (Slip/Fall)               Torts/Defamation(Libel/Slander)-DF
          Liens - LE                                                                                      Interfere with Contract Rights - IR
                                                       Negligence – Other - NO
          Quiet Title - QT
                                                                                                      Employment Torts(Wrongful Term)-WT
          Specific Performance - SP
                                                                                                      Other Torts - TO
     Condemnation/Eminent Domain-CD                                                                       Anti-trust - AI
     Other Real Property - RO                                                                             Fraud/Misrepresentation - FM
        Partition - PT                                                                                    Insurance- IN
                                                                                                          Legal Tort- LG
        Planning/Zoning - PZ
                                                                                                          Unfair Competition - UC
                     Probate                                                       Other Civil Filing Types
                                                       Construction Defect - CF                       Appeal from Lower Court
     Summary Administration - SU
                                                            Chapter 40                                   Transfer from Justice Court - TJ
     General Administration - FA                                                                         Justice Court Civil Appeal - CA
                                                            General
     Special Administration - SL                       Breach of Contract                             Civil Writ
     Set Aside Estates - SE                               Building & Construction - BC                     Other Special Proceeding - SS
                                                          Insurance Carrier - BF
     Trust/Conservatorships                               Commercial Instrument - CI                  Other Civil Filing
        Individual Trustee - TR                           Other Contracts/Acct/Judg. - CO                Compromise of Minor’s Claim - CM
        Corporate Trustee - TM                            Collection of Actions - CT                     Conversion of Property - CN
                                                          Employment Contract - EC                       Damage to Property - DG
     Other Probate - OP
                                                          Guarantee - GU                                 Employment Security - ES
                                                          Sale Contract - SC                             Enforcement of Judgment - EJ
                                                          Uniform Commercial Code - UN                   Foreign Judgment – Civil – FJ
                                                       Civil Petition for Judicial Review                Other Personal Property - PO
                                                                                                .        Recovery of Property - RE
                                                          Foreclosure Mediation - FO                     Stockholder Suit - ST
                                                          Other Administrative Law - AO                  Other Civil Matters – GC
                                                          Department of Motor Vehicles-DM                Confession of Judgment - CJ
                                                          Worker’s Compensation Appeal-SI                Name Change – Adult - NC
                                                                                                         Out of State Commission - OS
                                                                                                         Petition to Seal Criminal Records-PS

 III. Business Court Requested (If you check a box below, you must check an additional box above to determine case type.)
      NRS Chapters 78-88                               Investments (NRS 104 Art. 8)                       Enhanced Case Mgmt/Business
      Commodities (NRS 90)                             Deceptive Trade Practices (NRS 598)                Other Business Court Matters
      Securities (NRS 90)                              Trademarks (NRS 600A)



                        Date                                                     Signature of initiating party or representative

Nevada AOC – Planning and Analysis Division                                                                                       Form PA 201
2JDC - Revised 03/12/2010                                                                                                            Rev. 2.4E
 1   Code $3490
 2   Name_____________________________
     Address___________________________
 3          ____________________________
     Telephone Number___________________
 4   Acting In Proper Person
 5
 6
           IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
 7
 8                                IN AND FOR THE COUNTY OF WASHOE

 9
     In the Matter of the Petition Of:
10
11   ________________________________,                   Case No._____________________
           (Your present name)
12                                                       Dept. No._____________________
           For a change of name.
13   ________________________________/
14
15                            PETITION FOR LEGAL CHANGE OF NAME
                              U




16          ____________________________________________________, acting in proper person,
17                      (Your present name)

18   petitions this Court as follows:
                                                 I.
19
20          Petitioner,__________________________________, was born in __________________,
                                 (Your present name)                      (City)
21
     ______________________, on _________________________to _________________________
22         (State)                  (Date of birth)          (Father’s name)
23
     __________________ and _________________________________, who __________________
24                                  (Mother’s name)             (Were or were not)
     husband and wife.
25
26                                              II.
            I wish to change my name from______________________________________________
27
     to__________________________________________________ because:
28



     REVISED 7/2010 AA                           1                      N-1 PETITION
 1                               State reason for wanting name change

 2
     _____________________________________________________________________________
 3
     _____________________________________________________________________________
 4
 5   _____________________________________________________________________________

 6   _____________________________________________________________________________
 7   _____________________________________________________________________________
 8
     _____________________________________________________________________________
 9
     _____________________________________________________________________________
10
11   _____________________________________________________________________________

12   _____________________________________________________________________________
13   _____________________________________________________________________________
14
15                                                III.

16          I have _______________ been convicted of a felony.
                  (Have or have not)
17
             If I have been convicted of a felony, each offense, the date of conviction, the County and
18   State of conviction, and the final result are as follows:
19   _____________________________________________________________________________

20   _____________________________________________________________________________
21   _____________________________________________________________________________
22
     _____________________________________________________________________________
23
     _____________________________________________________________________________
24
25   _____________________________________________________________________________

26   _____________________________________________________________________________
27          I am not seeking a name change for any illegal purpose.
28



     REVISED 7/2010 AA                                   2                         N-1 PETITION
 1                                                  IV.
 2
            I currently reside at:
 3
                    ___________________________
 4                        (Address)
 5                  ____________________________
                    ____________________________
 6                  ____________________________
                          (Telephone number)
 7
 8   and I have lived there since ________________________ and have been a resident of Nevada
                               (When you moved to present address)
 9
     for ______________________________. My previous address was:______________________
10   (Length of time you have lived in Nevada)                   (Your previous address)
11
     ______________________________________, and I resided there for ____________________.
12   (County, State, Zip Code)                                     (How long you lived there)
13                                                  V.
14
            I am requesting that my name be legally changed to:
15
     ____________________________________________________________________________
16         (Clearly print your full new name as it will appear on all your legal documents)
17
                                                    VI.
18
            I (do or do not) _____________wish to have a new birth certificate issued showing my new
            0B




19
20   name as my original name.

21          This document does not contain the Social Security number of any person.

22          I declare, under penalty of perjury under the law of the State of Nevada, that the

23   foregoing is true and correct.

24
     DATE:______________________________
25                                                                _____________________________
26                                                                            (Print name)

27                                                                _____________________________
                                                                              (Signature)
28



     REVISED 7/2010 AA                               3                             N-1 PETITION
 1   Code: 2610
 2   Name:_______________________________
     Address: _____________________________
 3          ______________________________
     Telephone Number: ____________________
 4                  Appearing in Proper Person
 5
             IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
 6
                                 IN AND FOR THE COUNTY OF WASHOE
 7
 8
     In the Matter of the Petition of
 9
     ___________________________________,
10      (Your Current Name)                                   Case No. _______________________
11                                                            Dept. No. ______________________
                   For a Change of Name.
12   ___________________________________/
13
                                                     NOTICE
14
            On the ______ day of ___________________, 20______, a Petition was filed in the
15
     above-entitled Court by _______________________________________, requesting that the Court
16                                  (Print your current name here.)
17   legally change her/his present name of ___________________________________________ to
                                                    (Print your current name here.)
18
     __________________________________________.
19            (Print your new name here.)
20          Any opposition to this Petition should be filed with the above-entitled Court within ten (10)
21   days of the final publication of this Notice.
22          This document does not contain the Social Security number of any person.
23
24           DATED this _______ day of __________________________, 20______.

25
                                                            HOWARD W. CONYERS
26                                                          CLERK OF THE COURT
27                                                   By: _________________________________________
                                                                  Deputy Clerk
28

                                                        1
     REVISED 7/2010 AA                                                               N-1 NOTICE
 1   Code: 3715
     Name________________________________
 2   Address______________________________
            ______________________________
 3   Telephone No.________________________
     Acting in Proper Person
 4
 5
 6           IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
 7                              IN AND FOR THE COUNTY OF WASHOE
 8
 9   In The Matter of the Petition Of
10   ________________________________                                    Case No._________________
11         For change of Name.                                           Dept. No.________________
     ___________________________________/
12
13
14                                       PROOF OF PUBLICATION
15
            Attached is the proof of publication of the Notice.
16
            This document does not contain the Social Security number of any person.
17
            I declare, under penalty of perjury under the law of the State of Nevada, that the
18
            foregoing is true and correct.
19
20
            DATED this _____day of _________________, ______.
21
22
                                                                  ________________________________
23                                                                (Signature)

24                                                                ________________________________
                                                                  (Address)
25
                                                                  ________________________________
26
                                                                  ________________________________
27                                                                (Telephone number)

28



                                                     1
                              INDEX OF EXHIBITS


Exhibit Number          Number of Pages ______

Exhibit Description ____________________________________________________________




Exhibit Number ______   Number of Pages ______

Exhibit Description ____________________________________________________________




Exhibit Number ______   Number of Pages ______

Exhibit Description ____________________________________________________________
Exhibit _____
 1   Code: 3860
     Name________________________________
 2   Address______________________________
            ______________________________
 3   Telephone No.________________________
     Acting in Proper Person
 4
 5           IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
 6                              IN AND FOR THE COUNTY OF WASHOE
 7
 8   In The Matterof the Petition of:

 9
     _______________________________                                      Case No. ________________
10         (Your name)
                                                                          Dept. No. __________________
11                 For Change of Name.
     ______________________________________/
12
13                                      REQUEST FOR SUBMISSION
14
            It is hereby requested that the Petition for Name Change and all other documents filed herein
15
     be submitted to the Court for decision.
16
            This document does not contain the Social Security number of any person.
17
            I declare, under penalty of perjury under the law of the State of Nevada, that the
18
            foregoing is true and correct.
19
20
            Date:__________________________________
21
                                                          _____________________________________
22                                                              (Print name)
23                                                        _____________________________________
                                                                (Signature)
24
                                                          ____________________________________
25                                                              (Address)

26                                                        ____________________________________

27                                                        ____________________________________
                                                                (Telephone number)
28


                                                      1
 1   Code: 2792
 2
 3
 4         IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
 5
                               IN AND FOR THE COUNTY OF WASHOE
 6
     In the Matter of the Application of:
 7
 8
     _________________________________                           Case No.________________________
 9         (Your name)
                                                                 Dept. No. ______________________
10                  For a change of Name.
     _________________________________________/
11
12                                     ORDER CHANGING NAME

13          This Court, having reviewed the Petition of _______________________________________
                                                                 (Your present name)
14
15   to change ________________ name, proof of Publication having been filed and the statutory time
              (His or Her)
16
     to oppose having run and no opposition having been filed to the Petition,
17
18          IT IS HEREBY ORDERED that the name of __________________________________

19   be and hereby is, legally changed from_____________________________________________
20
     to ____________________________________________________________.
21
             IT IS HEREBY FURTHER ORDERED that a new birth certificate ___________issue
22                                                                         (shall or shall not)
     indicating Petitioner’s new name as Petitioner’s original birth name.
23
24
            Dated: ______________________________________
25
26
27                                                       ___________________________________
                                                               DISTRICT JUDGE
28



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