Form Ah-25 - Order For Change Of Name Record

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HAWAII STATE ARCHIVES
ORDER FOR CHANGE OF NAME RECORD
PRESENT NAME:
DATE:
FORMER NAME:
DATE OF DECREE:
PETITION NO:
Requester's relationship
Requestor's Name (please print)
to Petitioner
Requestor's Signature
Telephone:
Address:
Laws governing the disclosure of personal records limit public access to certain parts of records of name changes. [HRS 574-5(e) and
HRS 92F-13]. All items must be completed in full before this request will be processed.
TYPE OF SERVICE [check current fee schedule]
ORDER 9
DECREE 9
PETITION 9
ENTIRE FILE 9
DUPLICATION:
ORDER 9
DECREE 9
PETITION 9
ENTIRE FILE 9
CERTIFICATION:
ARCHIVES USE ONLY:
SERVICES
CHARGES
Cash _____
Check _____
No. of pages
Receipt No. ____________
No. of certifications
Rec'd By: ______________
Request Rec'd By: Phone 9
Mail 9
Postage/Fax
Archives 9
Mail 9
Handling Fee
PickUp:
Yes 9
No 9
TOTAL
Call when Ready:
AH-25 (rev. 6/98)

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