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Privacy Statement:
The information which you give in completing this form will be forwarded to the designated party for its use and will not be used for any other purpose or provided by us to any other parties. If you wish information concerning the privacy policy or the designated recipient, you should contact them directly.

Petitioners Name (Requesting Party)*
Address*
Street Address City State ZIP Code
Cellular Phone*
Home Phone*
Email*
Date of Birth*
Child's Name (First, Middle, Last)*
Proposed Name (First, Middle, Last)*
Place of Residence*
Street Address City State ZIP Code
Date of Birth*
Age*
Place of Birth (City, State or Country)*
Other Parent's Name*
Other Parent's Last Known Address
Street Address City State ZIP Code
If Other Parent's Whereabouts Are Unknown, Explain Why You Do Not Have Their Address
State The Reason For The Change Of Name*
If Minor Is 12 Years or Older, Does He/She Consent To The Name Change?
- Yes
- No
I Certify The Above Information Is Correct*

Contact info

If you have questions about your paperwork or our services, please take a few moments to complete the contact form in the banner at the top of this site. If the matter is urgent, please call one of our locations directly using the phone numbers listed below. Please be assured that we do not share or sell personal information without your permission.

Address

1376 East Santa Clara Street, San Jose, CA 95116

Phone

(408) 298-3377

Email

eli@ldahelp.com

DISCLAIMER: We are not attorneys. We can only provide self-help services at your specific direction. (LDA#91)

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Contact info

Address

Phone

Email

Ready for some help?

Accepted Payments

San Jose Location

Phone: (408) 298-3377