Fill and Sign the Affidavit in Support of Order for Publication and Order for Publication Minnesota Form

State of Minnesota District Court County Judicial District: Court File Number: Case Type: Name Change In the Matter of the Application of: First Middle Last Affidavit in Support of Order for Publication and Order for Publication On Behalf of: (Minor Name Change) (Minn. Stat. § 259.10, subd. 1) First Middle Last For a Change of Name to: First Middle Last The undersigned applicant has sworn/affirmed on oath and states that: 1. I have filed an Application for Name Change in _________________ County District Court for a change of name for the minor child (ren) from _____________________________ to __________________________________. 2a.  A Notice of Hearing and copy of the Application for Name Change was mailed to the non-applicant parent at his/her last known address and was returned. 2b.  An attempt at personal service of the Notice of Hearing and Application for Name Change was unsuccessful. 2c.  I do not know the address of the non-applicant parent. 3. The last known location of the non-applicant parent was: 4. The last known location of the non-applicant parent’s employment was: 5. The names and addresses of the non-applicant parent’s parents, brothers or sisters, children, and other close relatives are: 6. I have made the following efforts to get the non-applicant parent’s address from these persons: Therefore, I request that the Court allow publication of the Notice of Hearing. I further request that the Court set a new hearing date, if necessary. Sworn/affirmed before me Date: Applicant Deputy Court Administrator/Notary Public Order for Publication Based on the above Affidavit, IT IS ORDERED:  1. Notice shall be given by publication once a week for three consecutive weeks in the legal newspaper of the county of the other parent’s last known address.  2. The date and time of the Hearing on the Application for Name Change is , at ____.m. at the following address: .  3. Applicant’s request for publication is denied. Dated: Judge of District Court NAM207 State ENG Rev 4/05 www.courts.state.mn.us/forms Page 1 of 1