Form NAM202 "Application for Name Change of a Minor" - Minnesota

Form NAM202 or the "Application For Name Change Of A Minor" is a form issued by the Minnesota District Courts.

The form was last revised in September 1, 2015 and is available for digital filing. Download an up-to-date Form NAM202 in PDF-format down below or look it up on the Minnesota District Courts Forms website.

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Download Form NAM202 "Application for Name Change of a Minor" - Minnesota

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State of Minnesota
District Court
County
Judicial District:
Court File Number:
Case Type:
Name Change
Interpreter Requested
Language
In the Matter of the Application of:
First
Middle
Last
On Behalf of (current name of minor(s)):
Application for Name Change
of a Minor
First
Middle
Last
(Minn. Stat. § 259.10)
First
Middle
Last
For a change of name to (new name of minor(s)):
First
Middle
Last
First
Middle
Last
STATE OF MINNESOTA
)
) SS
COUNTY OF
)
The undersigned applicant states that:
1. This application is made in good faith, without intent to defraud or mislead.
2. The minor child(ren) whose name(s) are sought to be changed on this application have lived in the
State of Minnesota for at least six months immediately prior to the date of this application, and now
live at:
No.
Street
City/Town
State
Zip
County
3. I am/we are the: (
)
parent(s)
legal guardian
next of kin (
):
of the
check one
specify
minor child(ren).
NAM202
State
ENG
Rev 9/15
www.mncourts.gov/forms
Page 1 of 2
State of Minnesota
District Court
County
Judicial District:
Court File Number:
Case Type:
Name Change
Interpreter Requested
Language
In the Matter of the Application of:
First
Middle
Last
On Behalf of (current name of minor(s)):
Application for Name Change
of a Minor
First
Middle
Last
(Minn. Stat. § 259.10)
First
Middle
Last
For a change of name to (new name of minor(s)):
First
Middle
Last
First
Middle
Last
STATE OF MINNESOTA
)
) SS
COUNTY OF
)
The undersigned applicant states that:
1. This application is made in good faith, without intent to defraud or mislead.
2. The minor child(ren) whose name(s) are sought to be changed on this application have lived in the
State of Minnesota for at least six months immediately prior to the date of this application, and now
live at:
No.
Street
City/Town
State
Zip
County
3. I am/we are the: (
)
parent(s)
legal guardian
next of kin (
):
of the
check one
specify
minor child(ren).
NAM202
State
ENG
Rev 9/15
www.mncourts.gov/forms
Page 1 of 2
4. The current name(s) of minor child(ren) and date(s) of birth:
5. The name of the non-applicant parent(s):
The non-applicant parent is not known and his/her/their name(s) is/are not shown on the birth
certificate.
6. The address of the non-applicant parent(s) is/are:
No.
Street
City/Town
State
Zip
County
7. Applicant requests to have the name(s) of the minor child(ren) changed to:
8.
The criminal history of the following parties included in this application is:
___________________________________________________________________________________
___________________________________________________________________________________
The following parties included in this application have been convicted of a felony:
_
_
List name, date of offense, and state. If no criminal history, write “No criminal history.” If no felony convictions, write “No felony
convictions.”
9. Legal description of lands in the State of Minnesota upon which the minor child(ren) has/have a claim,
interest, or lien: (Provide the legal description and attach additional pages if necessary)
10. Other:
I declare under penalty of perjury that everything I have stated in this document is true and
correct. Minn. Stat. § 358.116.
Dated:
Co-Applicant’s Signature (Spouse)
Applicant’s Signature
Minor Signature (14 years or older)
Address
Minor Signature (14 years or older)
City
State
Zip
(
)
Telephone Number
E-mail address
NAM202
State
ENG
Rev 9/15
www.mncourts.gov/forms
Page 2 of 2
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