Philadelphia Bar Association Name Change Clinic Intake Form
The purpose of this form is to plan for the upcoming Name Change clinic, hosted by the LGBT Rights Committee of the Philadelphia Bar Association. This clinic is open to transgender, gender non-conforming, persons of trans experience, and/or non-binary Philadelphia residents who are otherwise unable to access legal services in order to change their legal name.

This is a one-day legal clinic for simple name change petitions, and is only open to current residents of Philadelphia County, PA. If you have a criminal history or other issues which may complicate the name change process, we will need to make a referral outside of this clinic.

The lawyers at this clinic will be providing pro bono representation, meaning that they will not charge attorneys' fees for the legal services provided and will endeavor to have costs waived as legally and ethically permissible. However, each petitioner will be responsible for any costs associated with the legal name change, including filing fees, publication fees, and judgment search fees. *Even those who seek and receive a waiver for court costs and fees will need to pay for the fingerprint card.*

Expected fees, if not waived by the court:

$333.23 for filing the petition
$20 for Family Court judgment search
$58.52 for Philadelphia Court of Common Pleas prothonotary judgment search
unknown amounts for out-of-county judgment searches, if needed
$20 for fingerprint card (will apply to everyone and must be handled prior to the clinic date)
$41.58 for each Certified Decree (a minimum of three or four copies will be needed, depending on individual circumstances)

Please note that there is NO guarantee that you will receive legal representation in any matter by completing this form, and by completing this form, you agree to have your information shared with the volunteers who are planning this clinic. Your information will be kept confidential among the group of clinic organizers.

You will receive an email follow-up prior to the clinic, either assigning you to an appointment time or letting you know that we are not able to assist you at this clinic.

IMPORTANT: If you do receive an appointment, you must bring the documents listed below with you to the appointment or your volunteer attorney will not be able to submit the name change petition for you:

1. Photo ID
2. Social Security card
3. Birth certificate
4. Fingerprint card ( $20 fee at Rosa Photo Van: https://www.certifixlivescan.com/fingerprinting-service-locations/rosa-photo-fingerprinting)

If you are looking for general legal advice, please contact the Philadelphia Bar Association Lawyer Referral Service at (215) 238-6333 or Community Legal Services at (215) 981-3700.
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