Form 61-6

NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA

[Caption. See § 3 of the Introduction in volume 1 of this manual.]

Original Petition for Change of Name of Child

1.Discovery in this case is intended to be conducted under [level 2/level 3] of rule 190 of the Texas Rules of Civil Procedure. [If level 3, see form 5-1.]

Preservation of Evidence: Respondent is put on notice to preserve and not destroy, con­ceal, or alter any evidence or potential evidence relevant to the issues in this case, including tangible documents or items in Respondent’s possession or subject to Respondent’s control and electronic documents, files, or other data generated by or stored on Respondent’s home computer, work computer, storage media, portable systems, electronic devices, online reposi­tories, or cell phone.

2.Petitioner objects to the assignment of this matter to an associate judge for a trial on the merits or presiding at a jury trial.

3.This suit is brought by [name of petitioner], Petitioner, who is the [parent/managing conservator/guardian of the person] of [name of child]. [The last three numbers of Petitioner’s driver’s license number are [numbers]./Petitioner has not been issued a driver’s license.] [The last three numbers of Petitioner’s Social Security number are [numbers]./Petitioner has not been issued a Social Security number.]

4.[Name of child] is a minor and resides in [county] County, Texas. [Name of child]’s present full legal name, address, and Social Security number are:

Name:

Address:

[Name of child] was born on [date]. The child was born in [city], [county] County, [state].

5.[Name of child] is not subject to the continuing jurisdiction of any court.

5.[Name of child] is subject to the continuing, exclusive jurisdiction of [this Court/the [designation] Court of [county] County, Texas].

6.[Name of child] [is/is not] subject to the registration requirements of chapter 62 of the Texas Code of Criminal Procedure.

7.Respondent, [name of respondent], is the [parent/possessory conservator] of [name of child]. [Respondent should be served with process [include if applicable: at [address, city, state, zip code]]./No service is necessary at this time.]

8.Petitioner requests the Court to grant a change of [name of child]’s name to [first, middle, and last names as they should appear in the order]. [Include if applicable: Petitioner asks the Court to order the Texas Department of State Health Services’ Vital Statistics Section to amend the child’s birth certificate to reflect this change of the child’s name.]

9.The reason for the requested change is [state specific reason for name change].

10.[Name of child]’s written consent to the change of name is attached to this petition.

11.Petitioner prays that the Court grant Petitioner’s Petition for Change of Name of Child.

Petitioner prays that citation and notice issue as required by law.

Petitioner prays for general relief.

   
[Name]
Attorney for Petitioner
State Bar No.:
[Email address]
[Address]
[Telephone]
[Fax]

Verification

I, [name of petitioner], Petitioner, swear under oath that I have personal knowledge of the facts stated in the Petition for Change of Name of Child and that they are true and correct.

   
[Name of petitioner]

SIGNED under oath before me on ______________________________.

   
Notary Public, State of Texas