N.Y. Civil Rights Law § 61: Contents

§ 61. Contents. 1. The petition shall be in writing, signed by the

petitioner and verified in like manner as a pleading in a court of

record, and shall specify the grounds of the application, the name, date

of birth, place of birth, age and residence of the individual whose name

is proposed to be changed and the name which he or she proposes to

assume. The petition shall also specify (a) whether or not the

petitioner has been convicted of a crime or adjudicated a bankrupt; (b)

whether or not there are any judgments or liens of record against the

petitioner or actions or proceedings pending to which the petitioner is

a party, and, if so, the petitioner shall give descriptive details in

connection therewith sufficient to readily identify the matter referred

to; (c) whether or not the petitioner is responsible for child support

obligations; (d) whether or not the petitioner's child support

obligations have been satisfied and are up to date; (e) the amount of a

child support arrearage that currently is outstanding along with the

identity of the court which issued the support order and the county

child support collections unit; (f) whether or not the petitioner is

responsible for spousal support obligations; (g) whether or not the

petitioner's spousal support obligations have been satisfied and are up

to date; and (h) the amount of spousal support arrearage that currently

is outstanding along with the identity of the court which issued the

support order.

2. If the petitioner stands convicted of a violent felony offense as

defined in section 70.02 of the penal law or a felony defined in article

one hundred twenty-five of such law or any of the following provisions

of such law sections 130.25, 130.30, 130.40, 130.45, 255.25, 255.26,

255.27, article two hundred sixty-three, 135.10, 135.25, 230.05, 230.06,

subdivision two of section 230.30 or 230.32, and is currently confined

as an incarcerated individual in any correctional facility or currently

under the supervision of the department of corrections and community

supervision or a county probation department as a result of such

conviction, the petition shall for each such conviction specify such

felony conviction, the date of such conviction or convictions, and the

court in which such conviction or convictions were entered.

3. Upon all applications for change of name by persons born in the

state of New York, there shall be annexed to such petition either a

birth certificate or a certified transcript thereof or a certificate of

the commissioner or local board of health that none is available.