Mescalero Tribal Court (2018) PO Box 227 / 159 Deer Trail Mescalero, NM 88340
MESCALERO APACHE TRIBAL COURT
MESCALERO APACHE RESERVATION, NEW MEXICO
Check List
Name Change
Affidavit
Petition for Name Change
Certificate of Indian Blood (CIB)
Creditor(s) submit recent statements
Court Order (if applicable)
NOTE: Where applicable, petitioner must be 14-years of age and accompanied by parent
to petition for Name Change. Petitioner must be an enrolled member of the Mescalero
Apache Tribe.
In order to properly process the Petition for Name Change, all necessary documents must be
attached at the time of filing.
Mescalero Tribal Court (2018) PO Box 227 / 159 Deer Trail Mescalero, NM 88340
MESCALERO APACHE TRIBAL COURT
MESCALERO APACHE RESERVATION, NEW MEXICO
COVER SHEET
Type of Case:
NAME OF PETITIONER(S): _____________________________________________________
Social Security Number or Tribal Census Number: ______________________________________
Telephone Number or Message Number: ______________________________________________
MAILING ADDRESS:
RESIDENTAL ADDRESS:
PLACE OF EMPLOYMENT:
This information is necessary to process your case, and will remain confidential. If a civil action, the court will collect the cost for mailing, to mail
the complaint to the respondent by certified mail. A copy of the Affidavit, Petition, Certificate of Indian Blood, and other court documents are to be
attached herein.
Thank you for your understanding: The Mescalero Tribal Court
Mescalero Tribal Court (2018) PO Box 227 / 159 Deer Trail Mescalero, NM 88340
MESCALERO APACHE TRIBAL COURT
MESCALERO APACHE RESERVATION, NEW MEXICO
, Cause No.______________________
Complainant/Petitioner(s),
Vs.
,
Respondent.
Enrollment No.: ____________________________
Address:_____________________________________
_________________________
I, , the complainant in this cause state that the following
statement(s) is/are true and correct to the best of my knowledge and belief:
____________________________________
Signature of Complainant/Petitioner
Date:
Print Name:
Enrollment No.
Address:
Mescalero Tribal Court (2018) PO Box 227 / 159 Deer Trail Mescalero, NM 88340
MESCALERO APACHE TRIBAL COURT
MESCALERO APACHE RESERVATION, NEW MEXICO
In the Matter of the Name Change of:
Cause No:
Petitioner
Date of Birth
COMES now Petitioner, alleges as follows:
THAT, the petitioner is an enrolled member of the Mescalero Apache Tribe, with enrollment number
_____________________;
THAT petitioner resides at _________________________________________________, and was born at
_____________________________________________________;
THAT the name proposed is not sought with any fraudulent or evil intent.
THEREFORE, the Petitioner, with all due respect prays to the Tribal Court for its order correcting and changing
the name of the Petitioner FROM_________________________________________
TO______________________________________, and that a Final Order be issued for the Petitioner to send to
the State of New Mexico Vital Statistics Office so that records can be changed accordingly.
NOTE: Upon completion of this process, a copy of the Change of Name Order will be need to be provided to the Mescalero Apache
Tribe’s Census Office, Bureau of Indian Affairs-Mescalero Agency, Mescalero Indian Health Service, and all outstanding Creditors
for proper documentation.
___________________________ _____________________
Signature of Petitioner Date
PETITION FOR CHANGE OF
NAME