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497329932 Keyword Campaignid 9761395179 Adgroupid 105629864288 Form

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IN THE ___________________ (Name of Court) COURT OF __________________ (County) , _____________________ (State) In the Matter of the Petition of ___________________________ (Name of Petitioner) PETITIONER For Change of Name CAUSE NO. ______,______ State of County of Affidavit of Good Character in Connection with Petition for a Name Change PERSONALLY appeared before me, the undersigned authority in and for said county and state, ____________________ (Name of Affiant) , who, having been being first duty sworn by the undersigned Notary Public, deposes and says: 1. I am a resident of ________________________________________________________ _____________________ (street address, city, county, state, zip code) . 2. I am not related to the _________________________ (Name of Petitioner) , Petitioner, either by blood or marriage. 3. I have known the Petitioner for _____ years. I personally know him to be a person of good character and know that he has a reputation as a person with good character and good standing in the community. Witness my signature this ___________________ (date) . _________________________________________ (Name and Signature of Affiant) SWORN to and subscribed before me, this the _____ day of _____________, 20____. _____________________________ NOTARY PUBLIC My Commission Expires: ____________________

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