IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

CIVIL DIVISION

IN RE:	CHANGE OF NAME OF	:	FILE NO.
:
:	NAME CHANGE

PETITION FOR NAME CHANGE

The Petitioner(s),	requests that this
Court order a change of name for
and in support thereof represents as follows:
Petitioner(s) is an adult individual, whose year of birth is	,
and who presently resides at	,
in the County of Lehigh
Petitioner is a citizen of the United States of America.
There are no judgments or decrees pending against the petitioner.
Petitioner(s) desires this change of name for the following reason(s):
Petitioner also requests the Court to change the name(s) of
, minor child/children
whose date(s) of birth is/are	, and
who is/are residing with the Petitioner at the above address.
WHEREFORE, Petitioner respectfully requests that this Court enter an Order
changing the name of Petitioner from	to
WHEREFORE, Petitioner respectfully requests that this Court enter an Order
changing the name of minor child/children from. (Insert initials only)
to

Respectfully submitted,

__________________________________

Petitioner(s)

Telephone Number

Email Address

Rev 11/2023	lccpa23

INSTRUCTIONS FOR FILING NAME CHANGE PETITION

Rachel A Wotring

2023-11-21