Form FM-NCA-100: Petition to Change the Name of an Adult

The Clerk's office will fill in the Cause Number and Court Number when you file this form.

For Name Change of, print the current full legal name of person asking for name change.

Look at your forms of identification (Social Security card, driver's license, passport, etc.) and your important documents (marriage licenses, insurance card, veteran's benefits, etc.) Make sure the names you write match those documents EXACTLY. Don't leave out a middle name if you have one. Include both last names if you have two last names.

2a. The name on your birth certificate: First, Middle (if you have one) and Last.

2b. Your current legal name (if different from birth certificate name, otherwise leave blank): First, Middle (if any) and Last.

2c. Other Names: enter the names you have used or been known by, as First, Middle (if any) and Last. Include the names from your driver's license, social security card, passport, past married names, etc., if they are different from your birth certificate or current legal name. If you don't have additional names, leave blank. If you need to list more names, add an additional page.

3a. Enter the name you ask the Court to change your name to: First, Middle (if any) and Last.

3b. Write the reason you want to change your name.

Enter your Home Address*: Street Address, City, State, Zip Code and County. *If you are a participant in the Office of the Attorney General's Address Confidentiality Program, please contact the Law Library for a different set of name change forms.

Enter your date of birth: Month, Day, Year. Sex listed on your birth certificate: mark Male or Female.

Enter your race. Enter where you were born: City of birth, County of birth, State of Birth and Country of Birth.

Enter the last 3 digits of your Social Security Number after XXX-XX-X, or check that you do not have a Social Security Number.

List all drivers' license numbers issued to you during the last 10 years: enter the last 3 digits and the State that Issued License for each. Or check that you have not had a driver's license during the last 10 years.

Are you required to register as a sex offender? Check Yes or No. If yes, you must attach proof that you notified the appropriate local law enforcement authority of your proposed name change.

Have you ever been charged with a Class A or B misdemeanor or a felony? Check Yes or No. If yes, write your FBI (Federal Bureau of Investigation) or SID (State Identification) number, if known, or any other reference number in a criminal history record system that identifies you.

If you don't know the number, write "unknown." Enter the FBI #, SID # and Other criminal history record system #.

List all Class A or B misdemeanors and felonies with which you have been charged, even if the case was dismissed or you were not convicted.

If you need more space, attach an additional page. If you do not know the information, contact the court clerk where the offense occurred.

For each Offense charged, enter the offense, the (Year Charged), the Court case/cause # in the County and State, and the Court's Name and # (Examples: County Court #0, 700th District Court, Superior Court).

Have you ever been convicted of a felony? Check Yes or No. Many people who have a felony conviction are not eligible for a name change order.

The court may order your name change only if: you ask to change your name to the primary name used in your criminal history record, or at least 2 years have passed since you received a certificate of discharge or completed court-ordered community supervision or juvenile probation, or you were pardoned. If any of these apply, you must attach proof to your filed Petition.

List all of your felony convictions here. If you list a conviction, make sure the charge for the conviction is also listed in 5C.

For each Felony Convicted, enter the felony, the (Year), the Court case/cause # in the County and State, and the Court's Name and #.

You believe this name change is in your interest or benefit and in the interest of the public. You ask the Court to make an Order to change your name, and any other Orders you may be entitled to.

Sign on Your Signature and enter the Date, your Printed Name, Phone, Street Address, City, State, Zip Code and County.

Enter the Fax # and the Email Address (if any).

Enter your name: First, Middle (if any) and Last. Enter your date of birth: Month, Day, Year. Enter your address: City, State, Zip Code and Country.

You declare under penalty of perjury that this form is true and correct.

You understand you could be criminally prosecuted for lying on this form.

You must attach these documents to your Petition.

Write "Exhibit" at the top of each document.

Check all that apply: a legible and complete set of your fingerprints on a fingerprint card in a form acceptable to the Texas Department of Public Safety and Federal Bureau of Investigations. Sign the card.

If you were convicted of a felony and you were pardoned, attach proof of pardon for each conviction.

If you were convicted of a felony and are asking to change your name to the primary name used in your criminal history record, attach your criminal history record.

If you were convicted of a felony and it has been at least 2 years since you were discharged or completed probation or parole, attach proof that you were discharged or that you completed probation or parole for each conviction.

If you are required to register as a sex offender, attach proof that you notified the appropriate local law enforcement authority of your proposed name change.