Questionnaire - Name Change (Adult) — The Lilly Law Firm, LLC

Questionnaire: Name Change

The following information will be needed to begin drafting documents for the name change. Additional information may be requested later by email. In addition to the information below, I’ll need a copy of your birth certificate and driver’s license. These can be sent to adam@thelillylawfirm.com. Please note - you cannot save the information in the form to complete later.

Complete (Current) Legal Name

Date of Birth

MM

DD

YYYY

State and County of Birth

Email

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

County of Residence

Marital Status

Currently Married

Divorced

Widowed

Never Married

Spouse's Name (if applicable)

Complete Desired Name

Please Re-Type the Complete Desired Name

Reason for Name Change (change in relationship, step-parent name, gender affirmation, etc)

Ready to Submit?

Check either box below, then "Submit" when you have completed your questionnaire.

As a reminder, in addition to the information above, I’ll need a copy of your birth certificate and driver’s license. These can be sent to adam@thelillylawfirm.com.