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VIRGINIA: IN THE CIRCUIT COURT OF THE CITY OF COLONIAL HEIGHTS

IN THE MATTER OF (your name) CHANGE OF GENDER STATUS

AT Law # _________

PETITION FOR CHANGE OF GENDER STATUS

TO THE HONORABLE JUDGES OF THE AFOREMENTIONED COURT:

Comes now, (your name) and petitions this Honorable Court to change her gender status to female and as grounds therefore respectfully represents as follows:

1. That your Petitioner resides in Brunswick County, Virginia;

2. That the Petitioner's father (decease as applicable) is (fathers name) and mother is (mothers name) nee (mothers maiden name);

3. That (your name) nee (your prior name if applicable) was born on the (birth date, in the city of ______ state of _____);

4. That she did, on the (date of surgery) in (place of surgery) under the care of (your surgeon), successfully undergo genital corrective surgery;

5. That she desires to correct her records to reflect the correct sex status;

6. That she requests the Court to change her gender status to that of female as evidenced by the enclosed affidavit and her signature on this petition.

WHEREFORE, your petitioner prays this honorable Court to change her sex designation to female and to this end all necessary and proper orders be entered pursuant to Section 32.1-269 of the Code of Virginia, as amended.

I Ask For This:

_________________________________

(your name)

(address)

(phone)

_____________________________end page 1 _______________________________

STATE OF VIRGINIA,

CITY OF (your city) , to-wit:

I, __________________________, a Notary Public in and for the

County and State aforesaid, do hereby certify that on the _________ day of

_______________________,20____, personally appeared before me and

subscribed and swore to the foregoing statement as being true and correct to the

best of her knowledge and belief.

My commission expires on the

day of

,20 .

GIVEN under my hand this

day of

,20 .

__________________________________

NOTARY PUBLIC

____________________________end page 2_________________________________

VIRGINIA: IN THE CIRCUIT COURT OF THE CITY OF (your city)

IN RE: (your name) CHANGE OF GENDER STATUS

AT Law # _________

ORDER

This day appeared (your name) upon her petition to correct records to reflect the correct gender status to Female.

Upon hearing the evidence, the Court finds the following:

1. That the sex of the petitioner has been corrected by medical procedure;

2. That she is a resident of (your county), Virginia;

3. That (your name) nee (your prior name if applicable) was born on the (birth date, in the city of ______ state of _____) to (fathers name), father (decease as applicable) and (mothers name) nee (maiden name), mother;

5. That the change of gender status to female is not sought for ant fraudulent purposes and would not otherwise infringe upon the rights of others.

It appearing to this Court that it is proper to do so, it is therefore ORDERED that the State Registrar shall amend the petitioner's certificate of birth to show the correct sex and upon submission of a certified court order showing the name change, show the new name pursuant to VA Code Sec. 32.1-269.

ENTERED this ________day of____________________,20____

___________________________

JUDGE

I ask for this:

______________________

(your name)

(address)

(phone)

I am not a lawyer however with a bit of research on my part I have found that these things can be accomplished with a little effort. I hope these sites and information are useful to you. If in doubt please have a lawyer look it over to be sure.

Dalelynn

VIRGINIA:

IN THE CIRCUIT COURT OF THE COUNTY OF PRINCE GEORGE

IN THE MATTER OF THE CHANGE OF NAME OF

<OLD NAME> an adult,

TO: <NEW NWME>

(OPTIONAL Remember this is Public Records) Social Security No.: <123-45-6789>

AT Law # _________

Petitioner

PETITION

TO THE HONORABLE JUDGES OF THE AFOREMENTIONED COURT:

1. That your petitioner (Ms. OR Mr.) <old name> resides at <address>, Virginia within the boundaries of Prince George County, Virginia.

2. <father> (deceased) is the father of <your name> and <mothers name> the mother. <fathers name> and <mothers name> were married on January 30, 19??? in the state of Virginia.

3. Your petitioner, (Ms. OR Mr <your name> was born on August 10, 19?? in Miama, Florida and given the name <your old name> and was given the Social Security No.: <123-45-6789>.

4. That your petitioner has been and is being treated for Gender Identity Disorder as outlined Harry Benjamin International Gender Dysphoria Association's, Standards Of Care For Gender Identity Disorders, diagnosed with the same and lives in the correct gender, wishes to have her name changed to reflect her true gender. See attachment from <therapist information>, L.C.S.W. dated 26 November, 200?

5. That your petitioner now wishes to resolve any confusion in her official records by changing her name and reflecting the correct gender.

6. That your petitioner's name has never been changed and the desire to do so and reflect her correct gender is not sought for a fraudulent purpose nor would a change of her name reflecting the correct gender infringe on the rights of others.

7. That your petitioner has no felony conviction record, and is not presently incarcerated or a probationer with any court.

WHEREFORE, your petitioner prays this honorable Court to change her name from the name of <old name> to <new name> and to this end all necessary and proper orders be entered pursuant to Section 8.01-217 of the 1950 Code of Virginia, (or your state code) as amended.

_________________________

Petitioner

Council does not represent your petitioner in this matter.

___________________________________________________end page 1_________________________________________________

STATE OF VIRGINIA,

COUNTY OF <COUNTY>, to-wit:

I, __________________________, a Notary Public in and for the

County and State aforesaid, do hereby certify that on the _________ day of

_______________________,20____, personally appeared before me and

subscribed and swore to the foregoing statement as being true and correct to the

best of her knowledge and belief.

My commission expires on the

day of

, 200?.

GIVEN under my hand this

day of

, 200?.

___________________________________

NOTARY PUBLIC

____________________________________page 2__________________________________

VIRGINIA:

IN THE CIRCUIT COURT OF THE COUNTY OF <COUNTY>

IN THE MATTER OF THE CHANGE OF NAME OF

<OLD NAME> an adult,

TO: <NEW NWME>

(OPTIONAL Remember this is Public Records) Social Security No.: <123-45-6789>

AT Law # _________

Petitioner

ORDER

This day came your petitioner, <your new nwme> Pro Se, upon her petition by leave of this Court to change her name change from <your old name> <your new name>.

It appearing to the Court from said petition filed therewith that the petitioner <your old name>, an adult, presently resides <your address>, Virginia; that petitioner was born <your old name>, on August 10, 19?? in Miama, Florida to the parents <fathers name> and <mothers name>. Having been treated for Gender Identity Disorder as outlined in the Harry Benjamin International Gender Dysphoria Association's, Standards Of Care For Gender Identity Disorders and diagnosed with the same, lives in the correct gender, wishes to have her name changed to reflect her true gender and reviewed the documentation attesting to the same. That she now wishes to resolve any confusion in her official records by changing her name and reflecting the correct gender. That she has no felony conviction record, and is not presently incarcerated or a probationer with any Court.

And the Court having considered said petition and being of the opinion that this change of name is not sought for a fraudulent purpose nor would a change of said petitioner infringe on the rights of others, and further being of the opinion that the application made herein should be granted, it is accordingly ADJUDGED, ORDERED and DECREED the name of <old name> be, and the same is hereby changed to <new name> and the Court doth further

ORDER that the Clerk of this Court shall make such reports of the name change of this adult as required by law.

ENTER

/200?

_________________________

JUDGE

I ASK FOR THIS:

_______________________

<phone>

page 3

Other legal sites that may be of use.

www.lawyers.com Has lots of information on free legal service

www.abanet.org State-by-state info on no or low-cost legl aid societies

www.nolo.com Inexpensive guidebooks on legal issues without an attorney

www.batlaw.org Bay Area TG Lawyers' Association

The sample here is for Virginia name change. The sites provided, All Law and Find Law, provides a comprehensive listing of all state codes and you will be able to find your states information there although many are on the Name and Gender Change page.

DaleLynn

Dalelynn

Organisation Intersex International

Sample Forms and Law Links