This form is intended for granting a change of name in a situation not involving a dissolution of marriage. See Tex. Fam. Code §§ 6.706, 45.105.
NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA
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See § 6 of the Introduction in volume 1 of this manual concerning protection of sensitive data in filed documents. |
[Caption. See § 3 of the Introduction in volume 1 of this manual.]
Order Granting Change of Name of Adult
On [date] the Court heard the Petition for Change of Name of Adult of [name of petitioner], Petitioner.
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Include appropriate recitations concerning appearances. See form 21-15. |
The Court finds that it has jurisdiction of the case and [name of petitioner].
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Select one of the following. |
The making of a record of testimony was waived with the consent of the Court.
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Or |
The record of testimony was duly reported by [[name, address]/the court reporter for the [designation] Court].
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Continue with the following. |
The Court finds:
1.Petitioner is an adult.
2.Petitioner’s full true name is [name].
3.Petitioner’s sex is [sex].
4.Petitioner’s race is [race].
5.Petitioner was born on [date] in [city], [county] County, [state].
6.Petitioner’s driver’s license number of any license issued within the past ten years is [driver’s license number and state of issuance].
7.Petitioner’s Social Security number is [number].
8.Petitioner has no FBI number or SID number.
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Or |
8.Petitioner’s FBI number is [number]. Petitioner’s SID number is [number].
9.No offense has been charged against Petitioner above the grade of class C misdemeanor.
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Or |
9.The following offense[s] [has/have] been charged against Petitioner above the grade of class C misdemeanor. The case number and the court of offense for [the/each] offense for which a warrant was issued or a charging instrument was filed or presented are as follows:
Offense:
Case number:
Court of offense:
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Repeat for each offense. |
10.Petitioner has not been finally convicted of a felony.
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Or |
10.Petitioner has been finally convicted of a felony, and the requirements of section 45.103(b) of the Texas Family Code have been met, thus allowing a change of name.
11.Petitioner is not subject to the registration requirements of chapter 62 of the Texas Code of Criminal Procedure.
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Or |
11.Petitioner is subject to the registration requirements of chapter 62 of the Texas Code of Criminal Procedure, and the requirements of section 45.103(c) of the Texas Family Code have been met, thus allowing a change of name.
12.[Petitioner’s change of name is in the interest or to the benefit of Petitioner and is in the interest of the public./Petitioner is requesting a change of name to the primary name used in Petitioner’s criminal history record information.]
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Include 13. if applicable. |
13.Petitioner has provided a copy of an authorization card certifying in accordance with article 58.059 of the Texas Code of Criminal Procedure that Petitioner is a participant in the address confidentiality program administered by the attorney general under subchapter B of chapter 58 of the Texas Code of Criminal Procedure.
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Continue with the following. |
IT IS ORDERED that Petitioner’s name is changed from [prior name] to [first, middle, and last names]. [Include if applicable: IT IS ORDERED that the Texas Department of State Health Services’ Vital Statistics Section shall amend Petitioner’s birth record to reflect this change of Petitioner’s name.]
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Include the following if applicable. |
IT IS ORDERED that this order is confidential and that the clerk of the Court shall prohibit the release of this order to any person.
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Continue with the following. |
IT IS ORDERED that all relief requested in this case and not expressly granted is denied.
SIGNED on ________________________________.
JUDGE PRESIDING