Name Change Petition Form - Circuit Court Of Illinois Page 3

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CIRCUIT COURT OF ILLINOIS
Sixth Judicial Circuit
Champaign County
_________________________________
Case No:_________________
Petitioner
ORDER FOR NAME CHANGE
This cause coming before this Court on the Petition for Change of Name filed herein, the Petitioner
being present personally and this Court having heard the testimony of Petitioner, finding that the
required Certificate of Publication has been filed, and being fully advised in the premises, finds that
said Petition should be allowed.
THEREFORE, IT IS ORDERED that the Petitioner’s name is changed to:
___________________________________________________________.
ENTERED this ______ day of __________________, 20___.
____________________________________
Judge
Revised: 12/12
Katie M. Blakeman
Clerk of the Sixth Judicial Circuit Court
Clerk of the Sixth Judicial Circuit Court
101 E. Main Street
101 E Main
Urbana, Illinois 61801
Urbana, IL 61801

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