Application For Change Of Name Of Minor - Ohio Probate Court Page 2
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1
2[Reverse of Form 21.2]
CASE NO. ____________________
□
The applicant requests a change of name of the minor from __________________________________
to __________________________________________________________________________________
for the following reason: ________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
The applicant states that the applicant will cause notice of the application to be published once in a
newspaper of general circulation in this county at least thirty (30) days before the hearing on this application.
In addition, notice will be given by the applicant to any non-consenting parent or alleged parent, whose
addresses are known, by certified mail, return receipt requested.
_________________________________________
______________________________________
Attorney for Applicant
Applicant’s Signature
_________________________________________
______________________________________
Typed or Printed Name
Typed or Printed Name
_________________________________________
______________________________________
Address
Address
_________________________________________
______________________________________
City
State
Zip
City
State
Zip
_________________________________________
______________________________________
Telephone Number (include area code)
Telephone Number (include area code)
Attorney Registration No. _____________________
JOURNAL ENTRY SETTING HEARING AND ORDERING NOTICE
The Court orders this application set for hearing on the ______ day of _____________________,
_________, at ______________ o’clock _____.m.
The applicant is ordered to cause notice of the
application to be given by one publication in a newspaper of general circulation in this county at least thirty
(30) days prior to the hearing date, as well as certified mail service, return receipt requested, if necessary,
as required by law.
______________________________________
Probate Judge
By:
______________________________________
Deputy Clerk
Print Form
FORM 21.2 – APPLICATION FOR CHANGE OF NAME OF MINOR
Amended: March 15, 2016
Discard all previous versions of this form
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