Worksheet for Name Changes


This page collects information that allows Verbeck Law to complete the forms required for a court-ordered name change. Not all the fields will necessarily apply to your case, but please try to give as much information as possible here. Ask us if you have any questions, of course. 


Name *
Date of Birth *
Date of Birth
Current home address *
Current home address
Give your present residential address in the county you live in.
Phone Number - Cell
Phone Number - Cell
Phone number - Business
Phone number - Business
This is required in counties that conduct background checks as a matter of course, like Santa Clara.
Please give city and country.
This is also required in counties that do background checks.
If more convenient, you can send us a scan of your license, and we can pull data for this question and the one above.
Driver's License expiration date
Driver's License expiration date
This information is kept confidential by both Verbeck Law and the courts, but counties that conduct background checks do require a CLETS filing with SS and immigration status.
This can help agencies differentiate between common names.
Include past legal names, maiden names, etc.
Do you certify that you're not under the jurisdiction of parole, probation, or any similar agency? *
Do you certify that you are not currently required by any court to register as a sex offender? *