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Fill and Sign the Adult Name Changenebraska Judicial Branch Form

Fill and Sign the Adult Name Changenebraska Judicial Branch Form

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Nebraska State Court Form CC 3:28 AFFIDAVIT IN SUPPORT OF _______________________ ________________________ New 06/18 IN THE _________________________________________ COURT OF __________________COUNTY, NEBRASKA (County or District) (county where original petition filed) ________________________________ (name of person listed as plaintiff in original action) Plaintiff vs. ________________________________ (name of person listed as defendant in original action) Defendant Case No.____________________ (case number assigned by clerk of court) AFFIDAVIT IN SUPPORT OF _______________________ ________________________ STATE OF NEBRASKA) ) ss: COUNTY OF _____________ ) (County where signed) I, __________________________, being duly sworn under oath, say: (your full name) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ****DO NOT SIGN UNTIL YOU ARE IN THE PRESENCE OF A NOTARY*** Date Signature (your signature) Your Full Name Your Full Street Address/P.O. Box City/State/ZIP Code Phone E-mail Address SUBSCRIBED AND SWORN to before me this ______ day of _____________, 20___. ________________________________ Notary Public Page 1 of 1 Affidavit CC 3:28 New 06/18

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