© 2017 Family Law Self-Help Center Order for Child’s Name Change
1
ORDR
Your Name:
Address:
Telephone:
Email Address:
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
In the Matter of the Application of:
_
__________________________________
(Parent’s name(s))
For Change of Name of the Minor Children:
_
__________________________________
(First child’s name)
_
__________________________________
and (Second child’s name or “N/A”)
CASE NO.: ____________________
DEPT: _____________________
ORDER FOR CHANGE OF MINOR’S NAME
This Order was submitted ( check one) after a hearing without a hearing before
the above-entitled court, and after a review of the pleadings and papers on file and the testimony
given, if any, this Court finds that the proposed name change for the above-named minor
child(ren) is in the best interest of the child(ren), and/or that there is clear and compelling
evidence that the substantial welfare of the child necessitates a name change.
NOW THEREFORE, IT IS HEREBY ORDERED that the name of the first child,
who was born on (first child’s date of birth) ___________________________________ in (city)
_______________________, (state) ____________________ shall be legally changed from
(clearly print the child’s current, full, legal name):
_____________________ ______________________ _______________________
(first) (middle) (last)
to: (clearly print the child’s new name)
_____________________ ______________________ _______________________
(first) (middle) (last)
Page 2 of 2 - Order for Child’s Name Change
The Department of Vital Statistics ( check one) shall / shall not issue a new birth
certificate for this child reflecting the name change above.
IT IS FURTHER ORDERED that the name of the second child, who was born on (date
of birth) ____________________________________ in (city) _______________________,
(state) ____________________ be legally changed from (clearly print the child’s current, full,
legal name):
_____________________ ______________________ _______________________
(first) (middle) (last)
to: (clearly print the child’s new name)
_____________________ ______________________ _______________________
(first) (middle) (last)
The Department of Vital Statistics ( check one) shall / shall not issue a new birth
certificate for this child reflecting the name change above.
DATED this ______ day of _______________________, 20____.
____________________________________
DISTRICT COURT JUDGE
Respectfully Submitted By:
________________________________ ________________________________
(First Parent’s signature) (Second Parent’s signature)
________________________________ _________________________________
(First Parent’s printed name) (Second Parent’s printed name)