This form contains 53 fields organized into 22 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Address
State Text
Enter the two-letter U.S. Postal Service abbreviation for the state where the address entered in “CITY” and “ZIP CODE” is located. Use uppercase letters (for example, CA).
Max length: 2 characters
Zip Code Text
Enter the five-digit ZIP Code for the attorney or party address you provided in “Street Address” and “City.” This field is required. If you have a four-digit ZIP Code extension, include it after a hyphen (for example, 12345-6789).
Attachments
Name and Information About the Person Whose Name Is to Be Changed (form NC-110) is attached to this form CheckBox
Check this box when you have attached the completed NC-110 form that provides the name and information of the person whose name you are asking the court to change.
Attorney
Attorney for Party Name Text
Enter the full legal name of the person or entity the attorney represents in this case. Complete this field if you are filing as an attorney. Format the entry with the party’s first name, optional middle initial, and last name (no abbreviations).
Attorney Details
State Bar Number Text
Enter your California State Bar number as issued by the State Bar of California. Required if you are an attorney; if you are a party without an attorney, leave this field blank. Enter only numeric digits, without spaces, hyphens, or other characters.
Name of Attorney or Party Without Attorney Text
Enter the full legal name: for attorneys, as it appears in your State Bar records (see STATE BAR NUMBER); for self-represented parties, your own full name. Include first name, middle initial (if any), and last name. Required.
Firm Name Text
Enter the full legal name of the law firm representing you in this case. Required if you are represented by an attorney under the “ATTORNEY OR PARTY WITHOUT ATTORNEY” section; leave blank if you are representing yourself. Use the firm’s official name exactly as registered, including any punctuation.
Street Address Text
Enter the complete street address for the attorney or party without attorney, including house number, street name, and suite, unit, or apartment number if applicable. Do not enter a P.O. Box. This field is required. After entering the street address, complete the City, State, and ZIP Code fields.
City Text
Required when completing the STREET ADDRESS field in the ATTORNEY OR PARTY WITHOUT ATTORNEY section. Enter the full city name for the address; do not use abbreviations.
Birth Certificate
wants a name change on their or their child's birth certificate, which was issued in this county CheckBox
Check this box if the petitioner does not reside in California and is requesting a court-ordered name change on a birth certificate issued by this county.
Request new birth certificate reflecting change of gender and name CheckBox
Check this box when you want the court to issue you a new birth certificate that reflects both your updated gender marker and your new name.
Case Information
Case Number Text
Enter the case number assigned to this matter by the court. If you have already been assigned a case number, type it exactly as it appears on your court documents, including all letters, numbers, and separators. If you do not yet have a case number, leave this field blank for the court clerk to complete.
Case Number Text
Enter the court-assigned case number exactly as it appears on your court documents. Include all letters, numbers, hyphens, and spaces in the same order. This field is required.
Case Short Title Text
Enter the short title of the case exactly as it appears on court pleadings. Format party names as “Petitioner v. Respondent” (for example, “Smith v. Jones”), using “v.” between names and no additional words. This field is required.
Certificate Request
Issuance of New California Certificate CheckBox
Check this box when you are requesting the court to issue a new California certificate reflecting the petitioner’s change of gender and/or name.
Petitioner requests issuance of a new birth certificate for petitioner’s child reflecting change of gender and change of name CheckBox
Check this box when you want the court to issue a new California birth certificate for your child that reflects your legal gender change and your name change.
Petitioner requests an order for the issuance of a new marriage license and certificate with a change of designation of the person as bride, groom, or having neither box checked and change of name CheckBox
Check this box when the petitioner wants a court order to issue a new marriage license and certificate reflecting both an updated gender designation (bride, groom, or neither) and a change of name.
Contact
Telephone Number Text
Enter the attorney’s or party without attorney’s daytime telephone number, including the area code. Format as XXX-XXX-XXXX (for example, 415-555-1234). If no telephone number is available, leave this field blank.
Attorney or Party Fax Number Text
Enter the attorney’s or party’s fax number, including area code, in the same format as Telephone No. (for example, 415-555-1234). If no fax number is available, leave this field blank.
Attorney or Party E-mail Address Text
Enter the e-mail address of the attorney or party listed in the Name field. Use a valid e-mail format (for example, [email protected]).
Court Information
Superior Court County Text
Enter the full name of the county where you are filing your petition to complete the label “SUPERIOR COURT OF CALIFORNIA, COUNTY OF.” Use the county’s full name (for example, Los Angeles), without abbreviation. This field is required.
Superior Court Street Address Text
Enter the street address of the Superior Court of California in the county you entered in “SUPERIOR COURT OF CALIFORNIA, COUNTY OF.” Provide the street number and street name; include suite, department, or room number if applicable. Do not enter a P.O. Box address. This field is required.
Superior Court Mailing Address Text
Enter the mailing address for the Superior Court of California, County of (as entered in “Superior Court of California, County of”). Include street number and name, P.O. box or suite number if applicable, in standard U.S. postal address format.
Superior Court City and ZIP Code Text
Enter the city name of the Superior Court’s address followed by a comma, a space, and the 5-digit ZIP Code (for example, “San Diego, 92101”). This field is required for all filings and must use the full city name and standard five-digit ZIP Code format.
Superior Court Branch Name Text
Required. Enter the official branch name of the court for the county listed in the “SUPERIOR COURT OF CALIFORNIA, COUNTY OF” field. Use the exact official name as provided by the court clerk (for example, “Downtown Courthouse Branch”). Do not use abbreviations or acronyms.
Form Actions
Print this form Button
Click this button to print the completed form.
Save this form Button
Click this button to save your current progress on the form.
Clear this form Button
Click this button to clear all entries from the form.
For your protection and privacy, please press the Clear This Form button after you have printed the form Button
Press this button for your protection and privacy after printing the form, to clear your data from the form.
Gender
female CheckBox
Check this box when the petitioner is requesting that the court recognize their gender and sex identifier as female.
male CheckBox
Check this box when the petitioner requests that the court recognize a change of the petitioner’s gender and sex identifier to male.
nonbinary CheckBox
Check this box when the petitioner, who is 18 years or older, is requesting a court order to change their gender and sex identifier to nonbinary.
Gender Identification
male CheckBox
Check this box when the petitioner is requesting that their legal gender and sex identifier be changed to male to conform with their gender identity as part of this petition.
male CheckBox
Check this box if you are requesting that your legal gender and sex identifier be changed to male to conform to your gender identity.
nonbinary CheckBox
Check this box when requesting that your legal gender and sex identifier be changed to nonbinary to conform to your gender identity.
Marriage Certificate
wants a name change on a marriage license, and was married in this county CheckBox
Check this box if the petitioner does not reside in California and is requesting a court order to change their name on a marriage license issued in this county.
Name Change
Petitioner has already obtained a decree of name change that petitioner wants reflected on the certificates checked in item 5. CheckBox
Check this box if the petitioner already has a certified court decree of name change and wants that name reflected on the requested certificates, and will attach a copy of the decree to the petition.
Petitioner requests that the court decree that petitioner’s name be changed, in order to conform to petitioner’s gender identity CheckBox
Check this box when the petitioner is asking the court to issue an order changing their name so it aligns with their gender identity.
Name Change Request
Petitioner requests an order for the issuance of a new birth certificate for petitioner reflecting the change of gender CheckBox
Check this box when you want the court to issue a new birth certificate for yourself that reflects your updated gender.
Change of name on child's new birth certificate CheckBox
Check this box when you are asking the court to issue a new birth certificate for your child that reflects your legal change of name.
Having neither box checked CheckBox
Check this box when you request a new marriage license and certificate and you do not want the person designated as bride or groom.
Navigation
WWW DOT COURTS DOT CA DOT GOV Button
This button links to the official California courts website. Click it to visit the website.
Petition Request
Petitioner requests that the court issue an order directing any interested persons to file written objections to show cause why the petition for change of name should not be granted CheckBox
Check this box when the petitioner wants the court to issue an order giving interested persons the opportunity to file written objections to the requested name change
Petition Requests
AND CHANGE OF NAME CheckBox
Check this box when you are requesting a change of name in addition to the recognition of change of gender and sex identifier.
AND ISSUANCE OF NEW CERTIFICATES CheckBox
Check this box when you want the court to issue new official certificates (for example, birth or marriage certificates) reflecting your legally recognized change of gender and sex identifier.
Petitioner
Petitioner Present Name Text
Enter the petitioner’s current full legal name (first, middle, and last) exactly as it appears on their existing legal documents or identification. This field is required; include any middle name or initial and do not use abbreviations.
Petitioner Details
Petitioner’s Name Text
Enter the full legal name of the petitioner filing this form, including given name(s) and family name. This field is required; type your name exactly as it appears on your legal documents.
Residence
Petitioner resides in this county CheckBox
Check this box when the petitioner lives in the county where the petition is filed to establish that the court is the proper venue for the name change request.
Petitioner does not reside in California CheckBox
Check this box when the petitioner lives outside California to establish that this court is the proper venue for the name-change request.
Signature
Petitioner's Signature Date Date
Enter the date the petitioner signs this declaration. Required. Use MM/DD/YYYY format (for example, 01/31/2023).
Petitioner’s Printed Name Text
Type or print the petitioner’s full legal name (first, middle, last) legibly using letters only. This field is required.
Attorney Signature Date Date
Enter the date you sign the petition in MM/DD/YYYY format. Only complete this field if you are the attorney signing in the '(SIGNATURE OF ATTORNEY)' field.
Attorney’s printed name Text
Enter the full name of the attorney representing the petitioner by typing or printing legibly. Complete this field only if an attorney signs in the SIGNATURE OF ATTORNEY section.