Florida Minor Child Name Change Consent Form

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Florida Consent to Minors Name Change

After filing the name change petition for a minor, the spouse of the child that did not file the name change request must get consent from the other parent. The other parent must fill out this form and return to the other spouse.

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IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
IN RE: THE NAME CHANGE OF
,
Petitioner.
CONSENT FOR CHANGE OF NAME (MINOR CHILD(REN))
I,{full legal name} , being sworn, certify that
the following information is true:
I am the birth or legal ( ) father ( ) mother of the minor child(ren) named in this case, and I give
consent for the following name changes:
Minor child(ren)’s complete present name(s):
(1)
(2)
(3)
(4)
(5)
(6)
Minor child(ren)’s name(s) to be changed to:
(1)
(2)
(3)
(4)
(5)
(6)
I understand that I am swearing or affirming under oath to the truthfulness of the claims
made in this consent and that the punishment for knowingly making a false statement includes fines
and/or imprisonment.
Dated:
Signature of Consenting Parent
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
STATE OF FLORIDA
COUNTY OF
Sworn to or affirmed and signed before me on by .
NOTARY PUBLIC or DEPUTY CLERK
[Print, type, or stamp commissioned name of notary or
clerk.]Florida Supreme Court Approved Family Law Form 12.982(d), Consent for Change of Name (Minor Child(ren)) (9/00)
Personally known
Produced identification
Type of identification produced
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE
BLANKS BELOW: [ N fill in all blanks]
I, {full legal name and trade name of nonlawyer} ,
a nonlawyer, located at {street} , {city} ,
{state} , {phone} , helped {name} ,
who is the [ / one only] petitioner or consenting parent, fill out this form.