Form 11 - Ex-Parte Petition To Change Infant Name (Page 2 of 2) in pdf

Form 11 - Ex-Parte Petition To Change Infant Name Page 2

Affidavit of Consent of Non-petitioning Parent

[31. Index No. & Year] Insert Index Number & the year it was purchased

[32. Fill in name(s)] Fill in the Petitioner name

[33. Fill in name(s)] Fill in the Current Infant Name

[34. Fill in name(s)] Fill in the New Infant Name

[35. Insert County where papers signed and notarized] State County

[36. Insert Name of Non-petitioning parent]

[37. Insert Your Name] Petitioning parents name

[38. SIGN BEFORE NOTARY] Sign only before a notary public

[39. Insert Name of Non-petitioning parent]

[40. Affidavit must be notarized] Document must be signed and notarized

Name Change Order

[41. Index No. & Year] Insert Index Number & the year it was purchased

[42. Fill in name(s)] Fill in the Petitioner name

[43. Fill in infant current name]

[44. Fill in infant new name(s)]

[45.Your Name]

[46. Insert date petition signed]

[47. Insert infant current name]

[48. Insert infant new name.]

[49. Insert infant current name]

[50. Insert infant date of birth.]

[51. Insert County, State and Country of birth.]

[52. Birth cert number.]

[53. Insert infant(s) new name(s).]

[54. Insert infant(s) new name(s).]

Litigation Back (Last page of entire packet)

[55. Index No. & Year] Insert Index Number & the year it was purchased

[56. Fill in name(s)] Fill in the Petitioner name

[57. Fill in name(s)] Fill in the Respondent name

[58. Insert name(s) of papers submitted] Put the Names of all of the

documents

[59. YOUR SIGNATURE] Signature

[60. PRINT YOUR NAME] Your name

[61. YOUR ADDRESS] Your address

[62. CITY, STATE ZIP CODE] City State and Zip Code

[63. YOUR PHONE NUMBER] Your telephone Number

Form 11 - Ex-Parte Petition To Change Infant Name Page 2