Form PC 51 Petition to Change Name - Michigan

Form PC51 is a Michigan Probate Court form also known as the "Petition To Change Name". The latest edition of the form was released in September 1, 2016 and is available for digital filing.

Download a PDF version of the Form PC51 down below or find it on Michigan Probate Court Forms website.

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PCS CODE: NAM
Approved, SCAO
For help filling out this form, go to michiganlegalhelp.org
TCS CODE: PNC
STATE OF MICHIGAN
FILE NO.
JUDICIAL CIRCUIT - FAMILY DIVISION
PETITION TO CHANGE NAME
COUNTY
Note: Every person 22 years of age or older who is requesting a name change must have a criminal background check. For details, go to
michiganlegalhelp.org.
In the matter of the name change of
Present first name(s), middle name(s), and last name(s) (type or print)
1. An action within the jurisdiction of the family division of circuit court involving the family or family members of person(s) named
above has/have been previously filed in
Court, Case Number
, was
assigned to Judge
, and
remains
is no longer
pending.
2. The name change is for
a. a married person who wishes to also include a name change for his/her
spouse.
minor child(ren), of whom the petitioner has legal custody.
(For a minor 14 years or older, written consent is required. See form PC 51b.)
b. an adult.
c. a minor, whose natural or adopted parents are
Parent
Deceased
and
.
Parent
Deceased
Both parents are deceased. The guardian is
.
(Attach letters of guardianship.)
Name
3. The name change is for the following reason:
4. The name change is not sought for any fraudulent intent.
5. The following person(s) seeking a name change has/have a criminal record:
6. Each person for whom a name change is sought has been a resident of the county for at least one year.
Note: Skip item 7 if the noncustodial parent consents to the name change or if there is not a noncustodial parent.
7. I have legal custody of the minor.
a. The noncustodial parent has had the ability to visit, contact, or communicate with the child and has regularly and
substantially failed or neglected to do so for a period of two years or more before the filing of this petition and either:
a support order has been entered, and the noncustodial parent has failed to substantially comply with the order
for a period of two years or more before the filing of this petition; or
a support order has not been entered and the noncustodial parent, having the ability to support or assist in
supporting the child, has failed or neglected to provide regular and substantial support for two years or more
before the filing of this petition.
b. The noncustodial parent has been convicted of child abuse
, criminal sexual conduct
(MCL 750.136b)
(MCL 750.520b,
, or assault with intent to commit criminal sexual conduct
and the child or a
750.520c, 750.520d, or 750.520e)
(MCL 750.520g)
sibling of the child was the victim.
(Attach judgment of sentence.)
c. The last known address of the noncustodial parent is:
.
The noncustodial parent is not living at the above address, and I have taken the following steps to locate him/her:
(SEE SECOND PAGE)
Do not write below this line - For court use only
PETITION TO CHANGE NAME
PC 51 (9/16)
MCL 333.2872, MCL 711.1, MCR 3.613
PCS CODE: NAM
Approved, SCAO
For help filling out this form, go to michiganlegalhelp.org
TCS CODE: PNC
STATE OF MICHIGAN
FILE NO.
JUDICIAL CIRCUIT - FAMILY DIVISION
PETITION TO CHANGE NAME
COUNTY
Note: Every person 22 years of age or older who is requesting a name change must have a criminal background check. For details, go to
michiganlegalhelp.org.
In the matter of the name change of
Present first name(s), middle name(s), and last name(s) (type or print)
1. An action within the jurisdiction of the family division of circuit court involving the family or family members of person(s) named
above has/have been previously filed in
Court, Case Number
, was
assigned to Judge
, and
remains
is no longer
pending.
2. The name change is for
a. a married person who wishes to also include a name change for his/her
spouse.
minor child(ren), of whom the petitioner has legal custody.
(For a minor 14 years or older, written consent is required. See form PC 51b.)
b. an adult.
c. a minor, whose natural or adopted parents are
Parent
Deceased
and
.
Parent
Deceased
Both parents are deceased. The guardian is
.
(Attach letters of guardianship.)
Name
3. The name change is for the following reason:
4. The name change is not sought for any fraudulent intent.
5. The following person(s) seeking a name change has/have a criminal record:
6. Each person for whom a name change is sought has been a resident of the county for at least one year.
Note: Skip item 7 if the noncustodial parent consents to the name change or if there is not a noncustodial parent.
7. I have legal custody of the minor.
a. The noncustodial parent has had the ability to visit, contact, or communicate with the child and has regularly and
substantially failed or neglected to do so for a period of two years or more before the filing of this petition and either:
a support order has been entered, and the noncustodial parent has failed to substantially comply with the order
for a period of two years or more before the filing of this petition; or
a support order has not been entered and the noncustodial parent, having the ability to support or assist in
supporting the child, has failed or neglected to provide regular and substantial support for two years or more
before the filing of this petition.
b. The noncustodial parent has been convicted of child abuse
, criminal sexual conduct
(MCL 750.136b)
(MCL 750.520b,
, or assault with intent to commit criminal sexual conduct
and the child or a
750.520c, 750.520d, or 750.520e)
(MCL 750.520g)
sibling of the child was the victim.
(Attach judgment of sentence.)
c. The last known address of the noncustodial parent is:
.
The noncustodial parent is not living at the above address, and I have taken the following steps to locate him/her:
(SEE SECOND PAGE)
Do not write below this line - For court use only
PETITION TO CHANGE NAME
PC 51 (9/16)
MCL 333.2872, MCL 711.1, MCR 3.613
Petition to Change Name (9/16)
File No.
8. I request the following name change(s):
(Type or print first name, middle name, and last name.)
FROM
TO
DATE OF BIRTH
Petitioner
month, day, year
Spouse
month, day, year
Minor child
month, day, year
Minor child
month, day, year
Minor child
month, day, year
Minor child
month, day, year
If you want a new live birth certificate, check item 9. A special order is not needed if you only want to add the changed name(s) to the original certificate(s).
9. I request the court to order the State Registrar to create a new live birth certificate that does not disclose the name of
at birth and to seal the original certificate.
Name
I declare that this petition has been examined by me and that its contents are true to the best of my information, knowledge,
and belief.
Date
/s/
Petitioner signature
Address
Name (type or print)
City, state, zip
Telephone no.
SIGNATURE OF PARENT/GUARDIAN FOR MINOR
Date
Date
/s/
/s/
Signature
Signature
Name (type or print)
Name (type or print)
Address
Address
City, state, zip
Telephone no.
City, state, zip
Telephone no.
CONSENT BY SPOUSE OF PETITIONER
If the petition is filed for a spouse, this consent must be signed by the spouse of the petitioner.
I am the spouse of the petitioner and consent to the granting of this petition to change my name.
Date
/s/
Signature
Address
Name (type or print)
City, state, zip
Telephone no.
/s/
Attorney signature
Address
Attorney name (type or print)
Bar no.
City, state, zip
Telephone no.

Download Form PC 51 Petition to Change Name - Michigan

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