NAMEANDGENDERCHANGE FOR AN ADULT
SUPERIOR COURT OF CALIFORNIA
COUNTY OF ORANGE
SELF-HELP CENTER
www.occourts.org/self-help
SHC-NC-05 (Rev. 10/19/2020)
Please visit our Self-Help Portal at: https://selfhelp.occourts.org
LamoreauxJusticeCenter
Room C-190
341TheCityDrive
Orange,CA
Cen
tralJusticeCenter
RoomG‐100
700CivicCenterDrive
SantaAna,CA
NorthJusticeCenter
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oom355
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Fullerton,CA
SuperiorCourt
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viceCenter
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MissionViejo,CA
HarborJusticeCenter
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oom107,Self‐HelpWindow
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1
st
Floor
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Without a Family Law case, to be filed at Central Justice Center
The Self-Help Center provides a free document review
service. To obtain an appointment to have your documents
reviewed, you must first fully complete the forms.
Pleaseuseblackink.
Self-Help Center Locations:
For m Appr oved for M andatory Use
L
-3008 [New October 8, 2020]
NAME CHANGE NOTICE OF RELATED CASES
CCP 1275 et seq., H&S Code 103430,
103425, 103435 & 103440
www.occourts.org
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address)
FOR COURT USE ONLY
TELEPHONE NO.:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
JUSTICE CENTER:
Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045
Lamoreaux - 341 The City Drive South, Orange, CA 92868-3205
CASE TITLE:
CASE NUMBER
NAME CHANGE NOTICE OF RELATED CASES
NOTICE: If you have an open case with Juvenile Court, are currently a juvenile dependent, a non-
minor dependent, or a ward of the Juvenile Court, you must file your request for name change with
the Juvenile Court at the Lamoreaux Justice Center.
The petitioner(s) must file this form with the Court when a name change case is initiated. A
related case means one or both petitioners and/or any minor children of the petitioner(s) are
involved or have been involved in other cases. Examples of related cases include family law
cases, domestic violence cases, child support collection cases, criminal cases, or juvenile
cases involving a minor child of one or both petitioners.
1. There are no other court cases involving either petitioner or a child of either petitioner listed
on the petition.
2. Listed below are other court cases involving either petitioner or any minor child
listed on the petition:
Case Number Case Name Person Involved
a.
b.
Date:
(TYPE OR PRINT NAME OF PETITIONER OR ATTORNEY) (SIGNATURE OF PETITIONER OR ATTORNEY)
(TYPE OR PRINT NAME OF PETITIONER OR ATTORNEY) (SIGNATURE OF PETITIONER OR ATTORNEY)
L-3008
Clear This Form
Print This Form
CM-010
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
TELEPHONE NO.: FAX NO.:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
CASE NAME:
CIVIL CASE COVER SHEET
Complex Case Designation
LimitedUnlimited
Counter Joinder
(Amount(Amount
demanded isdemanded Filed with first appearance by defendant
(Cal. Rules of Court, rule 3.402)
$25,000 or less)exceeds $25,000)
Items 1–6 below must be completed (see instructions on page 2).
1. Check one box below for the case type that best describes this case:
Auto Tort
Contract
Provisionally Complex Civil Litigation
(Cal. Rules of Court, rules 3.400–3.403)
Auto (22)
Breach of contract/warranty (06)
Uninsured motorist (46)
Other collections (09)
Antitrust/Trade regulation (03)
Other PI/PD/WD (Personal Injury/Property
Damage/Wrongful Death) Tort
Construction defect (10)
Insurance coverage (18)
Mass tort (40)
Rule 3.740 collections (09)
Asbestos (04)
Securities litigation (28)
Real Property
Product liability (24)
Environmental/Toxic tort (30)
Eminent domain/Inverse
condemnation (14)
Medical malpractice (45)
Insurance coverage claims arising from the
above listed provisionally complex case
types (41)
Other PI/PD/WD (23)
Wrongful eviction (33)
Non-PI/PD/WD (Other) Tort
Enforcement of Judgment
Business tort/unfair business practice (07)
Enforcement of judgment (20)
Civil rights (08)
Commercial (31)
Miscellaneous Civil Complaint
Defamation (13)
Residential (32)
RICO (27)
Fraud (16)
Drugs (38)
Other complaint (not specified above) (42)
Intellectual property (19)
Judicial Review
Miscellaneous Civil Petition
Asset forfeiture (05)
Partnership and corporate governance (21)
Petition re: arbitration award (11)
Employment
Writ of mandate (02)
Wrongful termination (36)
Other judicial review (39)
is2. This case is not complex under rule 3.400 of the California Rules of Court. If the case is complex, mark the
factors requiring exceptional judicial management:
Extensive motion practice raising difficult or novel
issues that will be time-consuming to resolve
Large number of witnesses a.
b.
f.
c.
3. Remedies sought (check all that apply):
punitive
a.
monetary
nonmonetary; declaratory or injunctive relief
c.
4. Number of causes of action (specify):
is
is not a class action suit.
5. This case
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF PARTY OR ATTORNEY FOR PARTY)
NOTICE
Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed
under the Probate Code, Family Code, or Welfare and Institutions Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result
in sanctions.
File this cover sheet in addition to any cover sheet required by local court rule.
If this case is complex under rule 3.400 et seq. of the California Rules of Court, you must serve a copy of this cover sheet on all
other parties to the action or proceeding.
Unless this is a collections case under rule 3.740 or a complex case, this cover sheet will be used for statistical purposes only.
Page 1 of 2
Cal. Rules of Court, rules 2.30, 3.220, 3.400–3.403, 3.740;
Cal. Standards of Judicial Administration, std. 3.10
www.courtinfo.ca.gov
Form Adopted for Mandatory Use
Judicial Council of California
CM-010 [Rev. July 1, 2007]
CIVIL CASE COVER SHEET
Other non-PI/PD/WD tort (35)
Professional negligence (25)
Other real property (26)
Other petition (not specified above) (43)
Other employment (15)
e.
d.
Substantial amount of documentary evidence
Large number of separately represented parties
Coordination with related actions pending in one or more courts
in other counties, states, or countries, or in a federal court
Substantial postjudgment judicial supervision
Unlawful Detainer
CASE NUMBER:
JUDGE:
DEPT:
If there are any known related cases, file and serve a notice of related case. (You may use form CM-015.)
6.
b.
Other contract (37)
ORANGE
700 Civic Center Drive West
Santa Ana
,
CA 92701
CENTRAL JUSTICE CENTER
1
Auto (22)–Personal Injury/Property
Auto Tort
case involves an uninsured
motorist claim subject to
arbitration, check this item
instead of Auto)
Uninsured Motorist (46) (if the
Damage/Wrongful Death
INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET
To Plaintiffs and Others Filing First Papers. If you are filing a first paper (for example, a complaint) in a civil case, you must
complete and file, along with your first paper, the Civil Case Cover Sheet contained on page 1. This information will be used to compile
statistics about the types and numbers of cases filed. You must complete items 1 through 6 on the sheet. In item 1, you must check
one box for the case type that best describes the case. If the case fits both a general and a more specific type of case listed in item 1,
check the more specific one. If the case has multiple causes of action, check the box that best indicates the primary cause of action.
To assist you in completing the sheet, examples of the cases that belong under each case type in item 1 are provided below. A cover
sheet must be filed only with your initial paper. Failure to file a cover sheet with the first paper filed in a civil case may subject a party,
its counsel, or both to sanctions under rules 2.30 and 3.220 of the California Rules of Court.
To Parties in Complex Cases
. In complex cases only, parties must also use the Civil Case Cover Sheet to designate whether the
case is complex. If a plaintiff believes the case is complex under rule 3.400 of the California Rules of Court, this must be indicated by
completing the appropriate boxes in items 1 and 2. If a plaintiff designates a case as complex, the cover sheet must be served with the
complaint on all parties to the action. A defendant may file and serve no later than the time of its first appearance a joinder in the
plaintiff's designation, a counter-designation that the case is not complex, or, if the plaintiff has made no designation, a designation that
the case is complex.
CASE TYPES AND EXAMPLES
Contract
Provisionally Complex Civil Litigation (Cal.
Rules of Court Rules 3.400–3.403)
Breach of Contract/Warranty (06)
Breach of Rental/Lease
Contract (not unlawful detainer
Antitrust/Trade Regulation (03)
Construction Defect (10)
Claims Involving Mass Tort (40)
Securities Litigation (28)
Environmental/Toxic Tort (30)
or wrongful eviction)
Contract/Warranty Breach–Seller
Plaintiff (not fraud or negligence)
Negligent Breach of Contract/
Warranty
Insurance Coverage Claims
Other Breach of Contract/Warranty
(arising from provisionally complex
case type listed above) (41)
Collections (e.g., money owed, open
Other PI/PD/WD (Personal Injury/
Property Damage/Wrongful Death)
Tort
book accounts) (09)
Collection Case–Seller Plaintiff
Asbestos (04)
Enforcement of Judgment
Other Promissory Note/Collections
Enforcement of Judgment (20)
Asbestos Property Damage
Case
Asbestos Personal Injury/
Insurance Coverage (not provisionally
Abstract of Judgment (Out of
Wrongful Death
complex) (18)
County)
Confession of Judgment (non-
Product Liability (not asbestos or
Auto Subrogation
toxic/environmental) (24)
domestic relations)
Other Coverage
Other Contract (37)
Medical Malpractice (45)
Sister State Judgment
Medical Malpractice–
Administrative Agency Award
Contractual Fraud
Physicians & Surgeons
(not unpaid taxes)
Petition/Certification of Entry of
Judgment on Unpaid Taxes
Other Contract Dispute
Other Professional Health Care
Malpractice
Real Property
Eminent Domain/Inverse
Other PI/PD/WD (23)
Other Enforcement of Judgment
Premises Liability (e.g., slip
Condemnation (14)
Case
and fall)
Wrongful Eviction (33)
Intentional Bodily Injury/PD/WD
Other Real Property (e.g., quiet title) (26)
Miscellaneous Civil Complaint
RICO (27)
(e.g., assault, vandalism)
Writ of Possession of Real Property
Mortgage Foreclosure
Intentional Infliction of
Other Complaint (not specified
above) (42)
Emotional Distress
Quiet Title
Negligent Infliction of
Declaratory Relief Only
Other Real Property (not eminent
domain, landlord/tenant, or
foreclosure)
Injunctive Relief Only (non-
Emotional Distress
Other PI/PD/WD
harassment)
Mechanics Lien
Non-PI/PD/WD (Other) Tort
Unlawful Detainer
Other Commercial Complaint
Business Tort/Unfair Business
Case (non-tort/non-complex)
Commercial (31)
Residentia
l (32)
Practice (07)
Civil Rights (e.g., discrimination,
false arrest) (not civil
Other Civil Complaint
(non-tort/non-complex)
Drugs (38) (if the case involves illegal
drugs, check this item; otherwise,
repor
t as Commercial or Residential)
Miscellaneous Civil Petition
harassment) (08)
Defamation (e.g., slander, libel)
Partnership and Corporate
(13)
Governance (21)
Judicial Review
Fraud (16)
Other Petition (not specified
Asset Forfeiture (05)
above) (43)
Intellectual Property (19)
Petition Re: Arbitration Award (11)
Civil Harassment
Professional Negligence (25)
Writ of Mandate (02)
Workplace Violence
Legal Malpractice
Other Professional Malpractice
(not medical or legal)
Other Non-PI/PD/WD Tort (35)
Writ–Administrative Mandamus
Writ–Mandamus on Limited Court
Elder/Dependent Adult
Abuse
Case Matter
Election Contest
Writ–Other Limited Court Case
Petition for Name Change
Review
Petition for Relief From Late
Employment
Claim
Other Judicial Review (39)
Wrongful Termination (36)
Other Employment (15)
Review of Health Officer Order
Notice of Appeal–Labor
Commissioner Appeals
Other Civil Petition
CM-010 [Rev. July 1, 2007]
Page 2 of 2
CIVIL CASE COVER SHEET
CM-010
To Parties in Rule 3.740 Collections Cases. A "collections case" under rule 3.740 is defined as an action for recovery of money
owed in a sum stated to be certain that is not more than $25,000, exclusive of interest and attorney's fees, arising from a transaction in
which property, services, or money was acquired on credit. A collections case does not include an action seeking the following: (1) tort
damages, (2) punitive damages, (3) recovery of real property, (4) recovery of personal property, or (5) a prejudgment writ of
attachment. The identification of a case as a rule 3.740 collections case on this form means that it will be exempt from the general
time-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 collections
case will be subject to the requirements for service and obtaining a judgment in rule 3.740.
Before you complete this petition, you should read the Instructions for Filing on the next page. You must answer all
questions and check all boxes that apply to you on this petition. You must file this petition in the superior court of the
county where the person whose name is to be changed resides.
is 18 years old or older
Petitioner requests a decree recognizing that the petitioner’s gender is changed to:
a.
b.
Petitioner requests that the court order that a new birth certificate be issued reflecting the gender and name changes sought by
this petition.
Petitioner requests that the court issue an order directing any interested persons to file written objections to show cause why
the petition for change of name should not be granted.
Petitioner provides the following information in support of this petition:
a.
The declaration below.
The information contained in the attachment (attach a completed copy of the attachment Name and Information About the
Person Whose Name Is to Be Changed (form NC-110)).
Page 1 of 2
PETITION FOR CHANGE OF NAME, RECOGNITION OF CHANGE
OF GENDER, AND ISSUANCE OF NEW BIRTH CERTIFICATE
Form Adopted for Mandatory Use
Judicial Council of California
NC-200 [Rev. September 1, 2018]
Code of Civil Procedure, § 1275 et seq.;
Health and Safety Code, §§ 103430, 103435
www.courts.ca.gov
1.
3.
4.
5.
6.
b–f.
(Instructions on next page)
Petitioner (present name):
female.
male.
nonbinary.
2.
PETITION OF (name):
CASE NUMBER:
PETITION FOR CHANGE OF NAME, RECOGNITION OF CHANGE OF
GENDER, AND ISSUANCE OF NEW BIRTH CERTIFICATE
NC-200
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
ATTORNEY OR PARTY WITHOUT ATTORNEY
STATE BAR NUMBER:
NAME:
FIRM NAME:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
Petitioner requests that the court decree that petitioner’s name is changed, in order to conform to petitioner's gender identity, to
c.
I declare under penalty of perjury under the laws of the state of California that the
request for a change in gender to (check one) is to conform my legal gender to my
gender identity and is not for any fraudulent purpose.
female nonbinary male
Date:
(TYPE OR PRINT NAME OF PETITIONER) (SIGNATURE OF PETITIONER)
(present name):
DECLARATION
and a resident of this county.
(proposed name):
700 Civic Center Drive West
Santa Ana, CA 92701
CENTRAL JUSTICE CENTER
INSTRUCTIONS FOR FILING A PETITION FOR CHANGE OF NAME AND GENDER
Where to File
The petition for change of name and gender must be filed in the superior court in the county where the petitioner is a resident.
1.
2.
Whose Name May Be Changed
The petition may be used to change your name and to obtain a court order recognizing a change of gender and for issuance of a
new birth certificate, if you are 18 or older. (Minors must use form NC-500.) If you were born in California, you may file the order
with the State Registrar and obtain a new birth certificate.
3.
Petition for Change of Name, Recognition of Change of Gender, and Issuance of New Birth Certificate (form NC-200)
Order to Show Cause for Change of Name to Conform to Gender Identity (form NC-125/NC-225)
Decree Changing Name and Order Recognizing Change of Gender Identity and for Issuance of New Birth Certificate
(form NC-230)
Court Hearing
If no objections are filed, the court will grant the petition without a hearing. A hearing date will be set if timely objections have been
filed. If there is a hearing, you will be sent a notice by the court. You may also check with the court after the deadline to see if a
hearing date has been set. Bring copies of all documents to the hearing. If the judge grants the name and gender change petition,
the judge will sign the original decree.
Birth Certificate
If you were born in California, to obtain a new birth certificate reflecting the change of gender, file a certified copy of the order within
30 days with the Secretary of State and the State Registrar and pay the applicable fees. You may write or contact the State
Registrar at:
Local courts may supplement these instructions. Check with the court to determine whether supplemental information is available.
For instance, the court may provide you with additional written information identifying the department that handles name and
gender change petitions, and the times when petitions are heard.
NC-200 [Rev. September 1, 2018] Page 2 of 2
What Forms Are Required
You need an original and two copies of each of the following documents:
a.
b.
Name and Information About the Person Whose Name Is to Be Changed (Attachment to Petition) (form NC-110)
c.
d.
4. Filing and Filing Fee
Prepare an original Civil Case Cover Sheet (form CM-010). File the original petition and Civil Case Cover Sheet with the clerk of
the court and obtain two filed-endorsed copies of the petition. A filing fee will be charged unless you qualify for a fee waiver. (If you
want to apply for a fee waiver, see Request to Waive Court Fees (form FW-001) and Information Sheet on Waiver of Superior
Court Fees and Costs (form FW-001–INFO).)
5. Filing the Order to Show Cause
Ask the court clerk to obtain a judge’s signature on the Order to Show Cause, then file the original order in the clerk’s office and
obtain filed-endorsed copies of the order.
6. Domestic Violence Confidentiality Program
In cases where the petitioner is a participant in the state address confidentiality program (Safe at Home), the petition, the order to
show cause, and the decree should, instead of giving the proposed name, indicate that the name is confidential and on file with the
Secretary of State. See Information Sheet for Name Change Proceedings Under Address Confidentiality Program (Safe at Home)
(form NC-400-INFO).
7.
8.
PETITION FOR CHANGE OF NAME, RECOGNITION OF CHANGE
OF GENDER, AND ISSUANCE OF NEW BIRTH CERTIFICATE
California Department of Public Health
Vital Records
MS 5103
P.O. Box 997410
Sacramento, CA 95899-7410
Phone: 916-445-2684
Website: www.cdph.ca.gov
Civil Case Cover Sheet (form CM-010)
e.
NC-200
Form Adopted for Mandatory Use
Judicial Council of California
NC-110 [Rev. September 1, 2018]
ATTACHMENT TO
PETITION FOR CHANGE OF NAME
Code of Civil Procedure, § 1275 et seq.
www.courts.ca.gov
Page 1 of 1
CASE NUMBER:
I declare under penalty of perjury under the laws of the State of California that (check one)
under the jurisdiction of the California Department of Corrections and Rehabilitation (in state prison or on parole) or in county
jail and (check one) required to register as a sex offender under Penal Code section 290.
I am not I am
I am not
I am
(3)
Male Female
NAME AND INFORMATION ABOUT THE PERSON
WHOSE NAME IS TO BE CHANGED
Attachment to Petition (form NC-100, form NC-200, or form NC-500)
(You must use a separate attachment for each person whose name is to be changed. If petitioner is a guardian of a minor, a
supplemental attachment, Declaration of Guardian (form NC-110G), must also be completed and attached for each minor whose name
is to be changed.)
(Continued) Petitioner applies for a decree to change the name of the following person:
and presently
Relationship of the petitioner to the person whose name will be changed:
If the person whose name will be changed is under 18 years of age, provide the names and addresses, if known, of the
following persons:
If the person whose name will be changed is 18 years of age or older, that person must sign the following declaration:
DECLARATION
(If petitioner is represented by an attorney, the attorney's signature follows):
(Each petitioner must sign this petition in the space provided below or, if additional pages are attached, at the end of the last
attachment.) I declare under penalty of perjury under the laws of the State of California that the information in the foregoing petition is
true and correct.
7.
(1)
(2)
(3)
(4)
(6)
b.
c.
d.
(1)
(2)
(4)
(5)
2WKHUVSHFLI\
e.
f.
NC-110
(1)
(2)
(3)
Sex (as stated on original birth certificate):
Present name (specify):
Proposed name (specify):
Born on (date of birth):
Born at (place of birth):
Parent (name): (address):
Parent (name): (address):
(5)
Self Other
under 18 years of age over 18 years of age
self
parent
guardian
near relative (indicate relationship):
Attachment
of
FOR CHANGE OF NAME
PETITION OF (Name of petitioner or petitioners):
Reason for name change (explain):
Current residence address (street, city, county, and zip code):
(Only if neither parent is living) Near relatives (names, relationships, and addresses):
Date:
(TYPE OR PRINT NAME OF PERSON WHOSE NAME IS TO BE CHANGED) (SIGNATURE OF PERSON WHOSE NAME IS TO BE CHANGED)
(SIGNATURE OF ATTORNEY)
(SIGNATURE OF PETITIONER)
(SIGNATURE OF PETITIONER)
Date:
(TYPE OR PRINT NAME)
Date:
(TYPE OR PRINT NAME)
Date:
(TYPE OR PRINT NAME)
ADD ADDITIONAL SIGNATURE LINES FOR ADDITIONAL PETITIONERS SIGNATURE OF PETITIONERS FOLLOWS LAST ATTACHMENT
1 1
Form Adopted for Mandatory Use
Judicial Council of California
NC-125/NC-225 [New September 1, 2018]
ORDER TO SHOW CAUSE FOR CHANGE
OF NAME TO CONFORM TO GENDER IDENTITY
Code of Civil
Procedure, § 1277.5
www.courts.ca.gov
Page 1 of 1
JUDGE OF THE SUPERIOR COURT
Date:
TO ALL INTERESTED PERSONS:
filed a petition with this court
for a decree changing name as follows:
Proposed name
Present name
a.
b.
c.
THE COURT ORDERS that any person objecting to the name changes described above must file a written objection that includes
the reasons for the objection within six weeks of the date this order is issued. If no written objection is timely filed, the court will
grant the petition without a hearing.
Petitioner (name):
to
to
to
1.
2.
A hearing date may be set only if an objection is timely filed and shows good cause for opposing the name change. Objections
based solely on concerns over the petitioner's actual gender identity shall not constitute good cause. (See Code Civ. Proc.,
§ 1277.5(b).)
3.
d. to
PETITION OF (Name of each petitioner):
FOR CHANGE OF NAME
CASE NUMBER:
ORDER TO SHOW CAUSE FOR CHANGE OF NAME
TO CONFORM TO GENDER IDENTITY
NC-125/NC-225
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
ATTORNEY OR PARTY WITHOUT ATTORNEY
STATE BAR NUMBER:
NAME:
FIRM NAME:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
700 Civic Center Drive West
Santa Ana, CA 92701
CENTRAL JUSTICE CENTER
JUDGE OF THE SUPERIOR COURT
SIGNATURE OF JUDGE FOLLOWS LAST ATTACHMENT
Date:
DECREE CHANGING NAME AND ORDER RECOGNIZING CHANGE
OF GENDER AND FOR ISSUANCE OF NEW BIRTH CERTIFICATE
Form Adopted for Mandatory Use
Judicial Council of California
NC-230 [Rev. September 1, 2018]
Code of Civil Procedure, §§ 1278, 1279;
Health & Safety Code, §§ 103430, 103435
Page 1 of 1
NC-230
THE COURT FINDS
2.
THE COURT ORDERS
THE COURT FURTHER ORDERS
THE COURT FURTHER ORDERS
5. A new birth certificate shall be issued reflecting the changes in name and gender.
3.
4.
FOR COURT USE ONLY
CASE NUMBER:
PETITION OF (name of petitioner):
FOR CHANGE OF NAME AND GENDER
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
ATTORNEY OR PARTY WITHOUT ATTORNEY
STATE BAR NUMBER:
NAME:
FIRM NAME:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
DECREE CHANGING NAME AND ORDER RECOGNIZING CHANGE OF
GENDER AND FOR ISSUANCE OF NEW BIRTH CERTIFICATE
All notices required by law have been given.
a.
Each person whose name is to be changed identified in item 3 belowb.
It appears to the satisfaction of the court that all the allegations in the petition are true and sufficient and that the petition
should be granted.
e.
is not
is required to register as a sex offender under section 290 of the Penal Code.
This determination was made
by using CLETS/CJIS
based on information provided to the clerk of the court
by a local law enforcement agency.
is changed to:
d.
Objections to the proposed change of name were made by (name):
f.
Other findings (if any):
The name of (present name):
is changed to (new name):
The gender of (new name):
c.
No objections to the proposed change of name were made.
a. female.
b. male.
of the above-entitled court.
The petition was duly considered:
a.
b.
in Courtroom:
at the hearing on (date):
without hearing.
nonbinary.c.
1.
If petitioner was born in California, a certified copy of this order shall be filed by petitioner within 30 days with the State Registrar.
When the State Registrar receives a certified copy of this order and payment of the applicable fees, the State Registrar shall
establish for the petitioner a new birth certificate reflecting the new name and the gender of the petitioner as it has been altered.
6.
700 Civic Center Drive West
CENTRAL JUSTICE CENTER
Santa Ana, CA 92701