Name Change
maiden
26.
Wife is granted restoration of her _____________ name of ____________________________.
(Maiden or Former)
(New Full Name)
Other Orders
27.
Other orders are as per the attached Exhibit Number___________, which is incorporated by
reference as if fully set forth herein.
__________________________________________________________________________________________
Court Costs
28.
Court costs are to be paid from the court cost deposit(s) previously posted.
Court costs are waived.
Waiver of Right to Rehearing
(If case is heard by a Commissioner pursuant to RSMo. §487.010 et. seq.)
We, the undersigned parties, do hereby acknowledge receipt of the findings and
recommendations of the commissioner, and waive the right to file a motion for rehearing in this
case.
(If heard by a Family Court Judge)
(If heard by a Family Court Commissioner)
Findings and Recommendations of Commissioner:
__________________________
___________
__________________________
___________
Commissioner
Date
Judge
Date
All orders and these findings and recommendations
of the Commissioner are confirmed and adopted as
the judgment of the court.
__________________________
___________
Judge
Date
A certified copy of this judgment is to be mailed to the following person(s):
(Check all applicable boxes)
Petitioner’s Attorney
Respondent’s Attorney
Guardian ad Litem
____________________________
____________________________
____________________________
(Signature of Petitioner’s Attorney)
(Signature of Respondent’s Attorney)
(Signature of Guardian ad Litem)
____________________________
____________________________
____________________________
(Street)
(Street)
(Street)
____________
______ ______
____________
______ ______
____________
______ ______
(City)
(State) (Zip)
(City)
(State) (Zip)
(City)
(State) (Zip)
_________________________
_________________________
_________________________
(Telephone Number)
(Telephone Number)
(Telephone Number)
Petitioner
Respondent
Third Party
____________________________
____________________________
____________________________
(Signature of Petitioner)
(Signature of Respondent)
(Signature of Third Party)
____________________________
____________________________
____________________________
(Street)
(Street)
(Street)
____________
______ ______
____________
______ ______
____________
______ ______
(City)
(State) (Zip)
(City)
(State) (Zip)
(City)
(State) (Zip)
_________________________
_________________________
_________________________
(Telephone Number)
(Telephone Number)
(Telephone Number)
Judgment of Dissolution of Marriage – Page 4 of 4
Form CCFC187-02/11