NAME CHANGE- INTAKE QUESTIONNAIRE

Privacy Policy

All information received from a client is strictly confidential. Our office takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

Your personal information will only be used in the event that you retain our office for the preparation of your name change petition and related court documents, and then only as necessary in the course of completing and filing your selected documents.

If you have any questions, please don't hesitate to contact our office at (408) 766-3532. We look forward to assisting you.

Contact information: Personal Information

Prefix

First name *

Middle name

Last name *

Emails

Email Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Type of Name Change

Current Legal Name

Proposed New Name

Personal Details

Criminal History

Minor Child Information (if applicable)

Court Filing Details

Fee Waiver Eligibility

Document Upload

DISCLAIMER

TrustPoint Disability & Legal Services LLC is a Legal Document Assistant (LDA #268, Santa Clara County) and is not an attorney. We cannot provide legal advice or representation. We can perform the following self-help services for you in connection with a legal matter in which you are representing yourself:

We can type or otherwise complete, as you specifically direct, legal documents that you have selected. We can provide you general published factual legal information that has been written or approved by an attorney to help you represent yourself. We can provide you published legal documents. We can file and serve legal forms and documents as you specifically direct.

If you require legal advice, we recommend consulting with a licensed California attorney.

Contact information: Personal Information

Type of Name Change

Who is the name change for?

Reason for name change

If other, please explain

Current Legal Name

Current First Name

Current Middle Name

Current Last Name

Proposed New Name

New First Name

New Middle Name

New Last Name

Personal Details

Date of Birth

Place of Birth

State-Issued ID or Driver's License Number

Are you a U.S. Citizen?

Social Security Number (Full digits)

Criminal History

Have you ever been convicted of a felony?

Are you currently on probation or parole?

Are you a registered sex offender?

If yes to any above, please provide details

Minor Child Information (if applicable)

Child's Current Full Legal Name

Child's Proposed New Name

Child's Date of Birth

Your relationship to the child

Other parent's full name

Other parent's address

Does the other parent consent to the name change?

Are both parents deceased?

Court Filing Details

County where you reside

How long have you lived in this county

Have you previously filed a name change petition?

If yes, provide case number and county

Fee Waiver Eligibility

Do you want to request a fee waiver?

Are you currently receiving public benefits?

Which benefits?

Monthly household income (before taxes)

Number of people in household

Are you unable to pay for basic needs (food, shelter, clothing)?

Document Upload

Upload copy of current government-issued ID

Upload any supporting documents (divorce decree, birth certificate, etc.)

DISCLAIMER

Acknowledgment

I understand TrustPoint is a Legal Document Assistant and does not provide legal advice or representation.

I certify that all information provided is true and correct.