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Here is the text we could read:

In the District Court of Utah

__________ Judicial District ________________ County

Court Address ______________________________________________________

_______________________________
Case Number

_______________________________
Judge

_____________________________________
(Minor’s name)

minor.

In the Matter of the Name Change of:

Consent to Minor’s Name Change

My name is ________________________________________________________, and
I solemnly swear or affirm that the following facts are true:

I have the following relationship to
________________________________________________________ (name of

minor), who was born on __________________ (date of birth), for whom a name
change petition has been filed. I am the minor's:

[ ] natural or adoptive father

[ ] natural or adoptive mother

[ ] custodian by court order (attach court order)

[ ] guardian by court order (attach court order)

[ ] other (explain): _________________________________________________

I have read the Petition for Minor’s Name Change and agree with it.

Consent to Minor’s Name Change

Approved November 19, 2004
Revised April 9, 2019

Page 1 of 2

ity, State, Zip

Name

ddress

hone

mail

I know that I have the right to discuss the name change petition with an attorney
of my choice.

I know I have the right to disagree with and contest the proposed name change,
by filing a written response to the name change petition.

I know I have the right to participate in these name change proceedings, either
by myself or through an attorney.

I understand that, if the court grants the name change, the new legal name of the
minor will affect me as follows:

[ ] The minor will no longer have the same name as I do.

[ ] The minor will have the same name as I do.

[ ] Other (explain): ________________________________________________

I understand that changing the minor’s legal name does not affect my legal
relationship to the minor. I will retain my lawful rights or obligations to the minor
which, depending on my situation, may include but not be limited to the following:
custody, guardianship, parent time, child support, day care, health care, tax
deductions, inheritance, and/or providing for the minor’s daily and ongoing
physical, emotional, and moral care and well-being.

I agree and consent to changing the minor's current name from:

First

Middle

Last

to this new legal name:

First

Middle

Last

and believe this name change is in the minor’s best interest.

I declare under criminal penalty under the law of Utah that everything stated in this document is true.

Signed at ______________________________________________________ (city, and state or country).

Signature ►

Printed Name

Date

Consent to Minor’s Name Change

Approved November 19, 2004
Revised April 9, 2019

Page 2 of 2

Consent to Minor’s Name Change

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Utah state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from legacy.utcourts.gov (2023-03)
Page(s): 2
Fields(s): 89
Average fields per page: 44
Reading Level: Grade 10
LIST Grouping(s): GO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

users1_name was name (1.00 conf)
users1_address_line_one was address (1.00 conf)
city_state_zip was city__state__zip (0.35 conf)
users1_phone_number was phone (1.00 conf)
email was email (0.38 conf)
page_field__1 was page_0_field_5 (0.31 conf)
district_court_utah was in_the_district_court_of_utah (0.34 conf)
page_field__2 was page_0_field_7 (0.31 conf)
judicial_district was judicial_district (0.38 conf)
page_field__3 was page_0_field_9 (0.31 conf)
court_address was court_address (0.42 conf)
consent_minor_name_change was consent_to_minor_s_name_change (0.34 conf)
county was county (0.39 conf)
page_field__4 was page_0_field_13 (0.31 conf)
page_field__5 was page_0_field_14 (0.31 conf)
page_field__6 was page_0_field_15 (0.31 conf)
page_field__7 was page_0_field_16 (0.31 conf)
page_field__8 was page_0_field_17 (0.31 conf)
page_field__9 was page_0_field_18 (0.31 conf)
page_field__10 was page_0_field_19 (0.31 conf)
page_field__11 was page_0_field_20 (0.31 conf)
docket_number was case_number (1.00 conf)
page_field__12 was page_0_field_22 (0.31 conf)
page_field__13 was page_0_field_23 (0.31 conf)
page_field__14 was page_0_field_24 (0.31 conf)
matter_name_change was in_the_matter_of_the_name_change_of (0.35 conf)
page_field__15 was page_0_field_26 (0.31 conf)
minor_name__1 was minor_s_name (0.42 conf)
page_field__16 was page_0_field_28 (0.31 conf)
page_field__17 was page_0_field_29 (0.31 conf)
and was and (0.41 conf)
page_field__18 was page_0_field_31 (0.31 conf)
page_field__19 was page_0_field_32 (0.31 conf)
page_field__20 was page_0_field_33 (0.31 conf)
judge was judge (0.39 conf)
page_field__21 was page_0_field_35 (0.31 conf)
swear_affirm_facts_true was i_solemnly_swear_or_affirm_that_the_following_facts_are_true (0.38 conf)
page_field__22 was page_0_field_37 (0.37 conf)
page_field__23 was page_0_field_38 (0.37 conf)
page_field__24 was page_0_field_39 (0.37 conf)
following_relationship was i_have_the_following_relationship_to (0.41 conf)
page_field__25 was page_0_field_41 (0.37 conf)
name__1 was my_name_is (0.33 conf)
name__2 was name_of (0.39 conf)
page_field__26 was page_0_field_44 (0.37 conf)
date_birth_name was date_of_birth_for_whom_a_name (0.42 conf)
page_field__27 was page_0_field_46 (0.37 conf)
page_field__28 was page_0_field_47 (0.37 conf)
page_field__29 was page_0_field_48 (0.37 conf)
minor_born was minor_who_was_born_on (0.43 conf)
page_field__30 was page_0_field_50 (0.31 conf)
page_field__31 was page_0_field_51 (0.37 conf)
change_petition_filed_minor was change_petition_has_been_filed__i_am_the_minor_s (0.38 conf)
page_field__32 was page_0_field_53 (0.37 conf)
natural_adoptive_father was natural_or_adoptive_father (0.33 conf)
page_field__33 was page_0_field_55 (0.37 conf)
read_minor_name_agree was i_have_read_the_petition_for_minor_s_name_change_and_agree_with_it (0.36 conf)
page_field__34 was page_0_field_57 (0.37 conf)
page_field__35 was page_0_field_58 (0.37 conf)
guardian_court_order_attach was guardian_by_court_order__attach_court_order (0.41 conf)
page_field__36 was page_0_field_60 (0.37 conf)
page_field__37 was page_0_field_61 (0.37 conf)
page_field__38 was page_0_field_62 (0.37 conf)
explain was other__explain (0.35 conf)
page__1 was page_1_of_2 (0.42 conf)
page_check__1 was page_0_check_0 (0.34 conf)
natural_adoptive_mother was natural_or_adoptive_mother (0.35 conf)
custodian_court_order_attach was custodian_by_court_order__attach_court_order (0.45 conf)
page_check__2 was page_0_check_3 (0.33 conf)
page_check__3 was page_0_check_4 (0.33 conf)
changing_minor_affect was i_understand_that_changing_the_minor_s_legal_name_does_not_affect_my_legal (0.42 conf)
page_field__39 was page_1_field_1 (0.36 conf)
minor_longer_name was the_minor_will_no_longer_have_the_same_name_as_i_do (0.32 conf)
minor_name__2 was the_minor_will_have_the_same_name_as_i_do (0.32 conf)
page_field__40 was page_1_field_4 (0.36 conf)
minor_affect_follows was minor_will_affect_me_as_follows (0.49 conf)
page_field__41 was page_1_field_6 (0.36 conf)
users1_signature was signature (1.00 conf)
page_field__42 was page_1_field_8 (0.36 conf)
page_field__43 was page_1_field_9 (0.36 conf)
believe_change_minor_interest was and_believe_this_name_change_is_in_the_minor_s_best_interest (0.32 conf)
signed was signed_at (0.36 conf)
city_state_country was city__and_state_or_country (0.47 conf)
signature_date was date (1.00 conf)
page__2 was page_2_of_2 (0.42 conf)
page_field__44 was page_1_field_15 (0.36 conf)
page_check__4 was page_1_check_0 (0.33 conf)
page_check__5 was page_1_check_1 (0.26 conf)
page_check__6 was page_1_check_2 (0.26 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Consent to Minor’s Name Change

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02