Name Change Clinic Registration

Clinic date: Thursday, November 21, 2019, 6-8 p.m.
Registration deadline: November 20

This clinic allows you to fill out name change forms. If you’d prefer to only attend the informational class, register here:

Name Change Clinic Registration

  • Date Format: MM slash DD slash YYYY
  • Household

    Tell us how many people are in your household. Count yourself. Count everyone that you are responsible for and anyone that is responsible for you. Count them even if you are not related. If you are a victim of domestic violence, do not count your abuser in your household.
  • Income and Assets

    List the amount of income and assets for each person in your household from the sources of income and assets identified below. If there is no income in that category, mark "N/A."
  • Income from wages

    Complete Weekly/Hourly Pay OR Monthly Salary OR Annual Salary
  • Other Income

    Enter amount of income from the following sources, if any.
  • Expenses

    Enter amount you pay for the following expenses, if any.
  • Filing

    The filing fees for a name change are over $80.