Paragraph 2 of Petition: Your Birth date and Place of Birth
Fill in your date of birth on the first blank. If you were born in the United States, check the first
box, and then fill in the county and state where you were born. If you were born outside the
United States, check the second box, and fill in the place where you were born on the space
provided.
Paragraph 3 of Petition: Old and New Names
On the first blank, fill in your current name. Spell it exactly as it appears on your birth record
or the other official records you want to change (including any middle name). On the second blank, fill
in the new name you want. Spell the new name exactly as you want it to appear on the birth
certificate or other official records in the future.
Paragraph 4 of Petition: Reasons for Name Change
Explain your reasons for the name change in this section. Be clear and reasonably complete,
but keep it short.
To finish filling out this Petition form, sign your name in the space provided on the last page, add
the date on which you are signing it, write your address and a daytime telephone number
where the Court staff can reach you if necessary. However, IF YOU ARE LIVING IN A
SHELTER FOR VICTIMS OF FAMILY VIOLENCE, DO NOT LIST THE ADDRESS OF THE
SHELTER. To do so would violate OCGA § 19-13-23. Instead, on the space for the
address, list only the name of the shelter and the state where it is located. Also, if your
address should be kept confidential because of family violence, do not write that address here.
Instead, you should write another address here, where you can be sure that you will receive
any information that is mailed to you by the Court.
Step 1 (b): Completing the Verification Form
The Verification form must be filed with the Petition to Change Name of Adult. Fill out the caption, the
top part, in the same way you filled it out on the Petition. Then, insert your name in the space after
the words “My name is.”
Now, before you sign this Verification, remember that you will be swearing under oath that the
information you have provided in the Petition is true. Therefore, you should re-read the Petition one
more time, from start to finish, to make sure it is all true. Do not sign it until you are in front of a
notary public. The notary must complete the rest of the Verification form after you sign it under oath.
Step 1 (c): Completing the Notice of Petition to Change Name of Adult
On the first blank in the main part of the form, fill in your current name. Spell it exactly as it appears on
your birth certificate or other official records. On the appropriate blanks, fill in the date you are filing
the Petition. On the next space, fill in the new name you want. Spell it exactly as you want it to
appear on any official records in the future. At the bottom, fill in the date you are signing the form, and
sign your name on the blank provided. Print or type your name and address on the lines below your
signature. Make sure your address is complete, so the News Daily can send you the proof of
publication.
Step 1 (d): Completing the Non-Domestic General Civil Case Filing Information Form