STATE OF INDIANA ) IN THE _____________ SUPERIOR/CIRCUIT COURT
)
SS:
COUNTY OF ______________ ) CASE
NO. ______________________________
IN RE THE NAME CHANGE OF: )
)
___________________________ )
Petitioner.
ORDER ON VERIFIED PETITION FOR CHANGE OF
NAME
Comes now the Court, having reviewed the Verified
Petition for Change of Name and the Notice
of Filing Proof of Publication, now finds as follows:
1.
That Petitioner’s current name is: _______________________________________________________.
2.
That Petitioner resides at:
_____________________________________________________________.
3.
That Petitioner is not seeking to defraud creditors by changing his/her
name.
4.
That Petitioner has not been convicted of a felony within the last ten
(10) years.
5.
That Petitioner wishes to change his/her name to:
_________________________________________.
WHEREFORE, IT IS ORDERED that Petitioner’s Petition for
Change of Name is GRANTED, and
Petitioner’s name is hereby changed to:
__________________________________________________________________________.
____________________ _______________________________
Date Judge,
_____________________ Court
Distribution:
_____________________________
Print your name
_____________________________
Mailing address
_____________________________
Town, State and Zip Code
_____________________________
Telephone Number
