Fill and Sign the A Copy of My Petition for Name Change is Attached Form

Name Change: Notice of Hearing, p. 1 Approved: November 19, 2004 (Name) (Address) (City) (Telephone) DISTRICT COURT, COUNTY, UTAH COURT’S ADDRESS: IN THE MATTER OF THE NAME CHANGE OF: , NOTICE OF HEARING ON PETITION FOR NAME CHANGE (petitioner’s name) Petitioner. Case No. ____________________ Judge _______________________ 1. I am the petitioner in this case. I have asked this Court for an order changing my name to . A copy of my Petition for Name Change is attached. (your proposed new name) 2. A hearing on the petition will be held before the Honorable , (judge’s name) District Court Judge, in courtroom number , in the district court located at the address shown above, on the day of , 20 , at a.m./p.m.3. If you have any objections to granting the Petition, file them in writing with the clerk of this Court, and mail a copy to me at my address, shown above. Name Change: Notice of Hearing, p. 2 Approved: November 19, 2004 DATED: ____________________________________ Petitioner CERTIFICATE OF DELIVERY On , I hand delivered, mailed by first class mail, (date) postage prepaid, a copy of the NOTICE OF HEARING ON PETITION FOR NAME CHANGE, along with a copy of the PETITION FOR NAME CHANGE, to: Name: Address: Name: Address: Name: Address: Name Address: ____________________________________ Petitioner