CAUSE NO - Dallas County



CAUSE NO. _______________________

IN THE MATTER OF IN THE _______________

THE MARRIAGE OF

____________________________________ DISTRICT COURT OF

AND

_____________________________________ DALLAS COUNTY, TEXAS

AFFIDAVIT OF PARTY

REQUESTING NAME CHANGE

COUNTY OF DALLAS STATE OF TEXAS

BEFORE ME, the undersigned authority, on this day personally appeared

___________________________________________________, Petitioner in the above named and numbered cause,

who being by me duly sworn, on oath stated:

“My name is __________________________________________________. I am the Petitioner in the above named

and numbered cause.

I have personal knowledge of the facts stated in this affidavit, and they are true and correct.

I am a _______________________________________ _____________________________ adult.

(Race) (Sex)

My Social Security Number is _______________________________________________________.

I have been a resident of Dallas County since the filing of the Original Petition.

I have been issued a Texas Driver’s License Number: _____________________________________.

I have never been arrested or charged with a criminal offense.

The change of name requested is in my best interest and to my benefit and in the interest of the public.

The name requested, _________________________________________________, is the name I had before I

married the respondent.

I am not asking for the resumption of my former name in order to attempt to evade any legal obligation.

I want to resume the use of my former name because I (have children/have no children) with that name

and I have been married to ________________________________________________ for ____________ years.

I have demonstrated good cause for a name change.

__________________________________________________

(Signature)

Signed and Sworn to before me on the ___________ day of __________________________________, 20_______.

__________________________________________________

Notary Public, State of Texas

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