Legal Packet

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NEW YORK )

) ss.

[COUNTY] COUNTY )

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IN THE MATTER OF THE APPLICATION OF:

[CURRENT FULL LEGAL NAME],

Petitioner.

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PETITION FOR CHANGE OF NAME

SUPREME COURT OF THE STATE OF NEW YORK

COUNTY OF [COUNTY]

Index No.: _______________

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COMES NOW Petitioner, [CURRENT FULL LEGAL NAME], and files this Petition for

Change of Name, and in support thereof states as follows:

JURISDICTION

1. Under N.Y. Civ. Rights Law § 60, "The supreme court shall have power to change

the name of any person born in this state or domiciled in this state at the

time of making the application, or any native of this state born outside the

same, in the manner provided in this article."

1. Under N.Y. Civ. Rights Law § 61, "A petition for leave to assume another name

may be made by a resident of the county in which he or she resides, to the

county court of such county, or to the supreme court in such county."

1. Petitioner is a resident of [COUNTY] County, New York, and has been a resident

of this county for at least [NUMBER] months/years.

PETITIONER INFORMATION

1. Petitioner's current full legal name is: [CURRENT FULL LEGAL NAME]

1. Petitioner desires to change name to: [NEW FULL LEGAL NAME]

1. Petitioner's date of birth: [DATE OF BIRTH]

1. Petitioner's place of birth: [CITY], [STATE]

1. Petitioner's Social Security Number: [XXX-XX-XXXX]

1. Petitioner's current address: [STREET ADDRESS], [CITY], NY [ZIP]

1. Petitioner's driver's license number: [STATE] [NUMBER]

REASON FOR NAME CHANGE

1. Under N.Y. Civ. Rights Law § 63, "If the court to which the petition is made

shall be satisfied thereby that the petitioner is a resident of the county,

and that there is no reasonable objection to the change of name proposed, and

that the petition is not made with intent to defraud creditors or avoid debts

or obligations or to evade law enforcement, and that petitioner's true

identity is established, the court shall make an order setting a time and place

for hearing..."

1. Petitioner desires to change [his/her/their] name for the following reason(s):

[Check all that apply and provide details:]

[ ] Marriage / Return to maiden name

[Explain]

[ ] Divorce

[Explain]

[ ] Adoption

[Explain]

[ ] Gender identity / Gender affirmation

[Explain]

[ ] Personal preference

[Explain]

[ ] Religious reasons

[Explain]

[ ] Professional reasons

[Explain]

[ ] Other: [Explain in detail]

1. Petitioner states that this name change is not being sought to:

• Defraud creditors
• Avoid debts or obligations
• Evade law enforcement
• Escape criminal liability
• Cause injury to any individual

BACKGROUND AND CERTIFICATIONS

1. Petitioner has [never] been convicted of a felony.

[If yes, provide details:] [List offense(s), case number(s), court(s), and

date(s) of conviction. Explain rehabilitation and why name change should be

granted.]

1. Petitioner [has/has not] previously filed a petition for change of name in

this or any other court.

[If yes, provide details:] [Case number, court, date, and outcome]

1. Petitioner [is/is not] currently involved in any pending legal proceedings.

[If yes, provide details:]

1. Petitioner states that there is no reasonable objection to the proposed name

change.

PUBLICATION

1. Under N.Y. Civ. Rights Law § 64, "Upon the hearing of the petition, if it

shall appear that the petitioner has given due notice of the time and place

of such hearing, by publishing the same once in each week for four successive

weeks previous to the time of such hearing in a newspaper to be designated

by the court, and that there is no reasonable objection to the change of name

proposed..."

1. Petitioner requests that the court designate the following newspaper for

publication of notice:

[NEWSPAPER NAME]

[NEWSPAPER ADDRESS]

PRAYER FOR RELIEF

WHEREFORE, Petitioner respectfully requests that this Court:

a) Order publication of notice of this petition in a newspaper designated by the

Court, once each week for four successive weeks;

b) After due proof of publication, enter an Order changing Petitioner's name from

[CURRENT NAME] to [NEW NAME];

c) Direct the appropriate authorities to update Petitioner's records to reflect

the name change;

d) Grant such other and further relief as the Court deems just and proper.

VERIFICATION

I, [CURRENT FULL LEGAL NAME], affirm under the penalties of perjury pursuant to

N.Y. Penal Law § 210.45 that I am the Petitioner in this matter; that I have read

the foregoing Petition; and that the facts stated therein are true and correct to

the best of my knowledge, except as to matters alleged on information and belief,

which I believe to be true.

I further certify that I am not changing my name to defraud creditors, avoid debts

or obligations, evade law enforcement, escape criminal liability, or cause injury

to any individual.

Dated: _____________, 20___

______________________________

[SIGNATURE]

[CURRENT FULL LEGAL NAME, printed]

[ADDRESS]

[CITY, STATE, ZIP]

[PHONE NUMBER]

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FILING INSTRUCTIONS

Supreme Court of New York - [County] County

Court: Supreme Court of New York, [County] County

Address: [County Courthouse Address]

Filing Fee: Approximately $210 (varies by county)

Fee Waiver: Request "Poor Person Order" from clerk

Publication Requirements:

Under N.Y. Civ. Rights Law § 64, you must:

1. After filing, the court will designate a newspaper
2. Publish notice once each week for FOUR successive weeks
3. File proof of publication (affidavit from newspaper) with the court
4. Publication costs approximately $50-200 depending on newspaper

Required Documents:

1. Petition for Change of Name (this document)
2. Certified copy of your birth certificate
3. Valid government-issued photo ID (driver's license, passport, state ID)
4. Proof of New York residency (utility bill, lease, voter registration)
5. Background check (some counties require this)
6. Filing fee or fee waiver request

After the Order is Granted:

1. Get certified copies of the Order from the clerk (cost: approximately $5-10 per copy)
2. Update your Social Security card at the Social Security Administration
3. Update your driver's license at the DMV within 30 days
4. Update your birth certificate (if born in New York) with the Department of Health
5. Update banks, employers, schools, insurance, and other accounts

Key Statutory References:

• N.Y. Civil Rights Law § 60 — Supreme court power to change name
• N.Y. Civil Rights Law § 61 — Petition for name change
• N.Y. Civil Rights Law § 62 — Contents of petition
• N.Y. Civil Rights Law § 63 — Court order for hearing
• N.Y. Civil Rights Law § 64 — Notice of hearing; publication
• N.Y. Civil Rights Law § 65 — Order for change of name
• N.Y. Civil Rights Law § 66 — Certified copy of order to be filed
• N.Y. Civil Rights Law § 67 — Effect of order

Court Locations by Major County:

• New York County (Manhattan): 60 Centre Street, New York, NY 10007
• Kings County (Brooklyn): 360 Adams Street, Brooklyn, NY 11201
• Queens County: 88-11 Sutphin Boulevard, Jamaica, NY 11435
• Bronx County: 851 Grand Concourse, Bronx, NY 10451
• Richmond County (Staten Island): 26 Central Avenue, Staten Island, NY 10301
• Nassau County: 100 Supreme Court Drive, Mineola, NY 11501
• Suffolk County: 1 Court Street, Riverhead, NY 11901

Legal Aid Resources:

• Legal Aid Society (NYC): (212) 577-3300
• LawHelpNY: https://www.lawhelpny.org
• NYC Bar Legal Referral Service: (212) 626-7373
• LSC Finder: https://www.lsc.gov/about-lsc/what-legal-aid/find-legal-aid

Important Notes:

• The court may waive publication requirements in certain circumstances (e.g., safety concerns)
• If you have a criminal history, the court will carefully review your petition
• The name change does NOT affect your legal obligations, debts, or criminal record
• You must notify the court if you are involved in any pending legal proceedings

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Jurisdiction-correct document templates. Not legal advice.

Document Version: NY-NAME-2026-01

Last Updated: March 2026

Statutory Reference: N.Y. Civil Rights Law Article 6, §§ 60-67