Fill and Sign the California Name Change California Name Change Form

CM-010 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address): TELEPHONE NO.: FAX NO.: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NAME: In re the Petition of FOR COURT USE ONLY CASE NUMBER: CIVIL CASE COVER SHEET Unlimited Limited (Amount (Amount demanded demanded is exceeds $25,000) $25,000 or less) Complex Case Designation Counter Joinder Filed with first appearance by defendant (Cal. Rules of Court, rule 1811) JUDGE: DEPT: Items 1-5 below must be completed (see instructions on page 2). 1. Check one box below for the case type that best describes this case: Auto Tort ContractProvisionally Complex Civil Litigation Auto (22) Breach of contract/warranty (06)(Cal. Rules of Court, rules 1800-1812) Uninsured motorist (46) Collections (09) Antitrust/Trade regulation (03) Other PI/PD/WD (Personal Injury/ Property Insurance coverage (18) Construction defect (10)Damage/Wrongful Death) Tort Other contract (37) Mass tort (40) Asbestos (04) Real Property Securities litigation (28) Product liability (24) Eminent domain/Inverse Environmental/Toxic tort (30) Medical malpractice (45) condemnation (14) Insurance coverage claims arising from the Other PI/PD/WD (23) Wrongful eviction (33) above listed provisionally complex case Non-PI/PD/WD (Other) Tort Other real property (26) types (41) Business tort/unfair business practice (07) Unlawful Detainer Enforcement of Judgment Civil rights (08) Commercial (31) Enforcement of judgment (20) Defamation (13) Residential (32) Miscellaneous Civil Complaint Fraud (16) Drugs (38) RICO (27) Intellectual Property (19) Judicial Review Other complaint (not specified above)42 Professional negligence (25) Asset forfeiture (05) Miscellaneous Civil Petition Other non-PI/PD/WD tort (35) Petition re: arbitration award (11) Partnership and corporate governance (21) Employment Writ of mandate (02) Other Petition (not specified above) (43) Wrongful Termination (36) Other judicial review (39) Other employment (15) 2.This case is is not complex under rule 1800 of the California Rules of Court. If case is complex, mark the factors requiring exceptional judicial management: a. Large number of separately represented partiesd. Large number of witnesses b. Extensive motion practice raising difficult or novel e. Coordination with related actions pending in one or more courts issues that will be time-consuming to resolve in other counties, states, or countries, or in a federal court c. Substantial amount of documentary evidence f. Substantial post-judgment judicial supervision 3.Type of remedies sought ( check all that apply): a. monetary b. nonmonetary; declaratory or injunctive reliefc. punitive 4. Number of causes of action (specify):5.This case is is not a class action suit. 6.If there are any known related cases, file and serve a notice of related case. (You may use form CM-015.)Date: 6 (TYPE OR PRINT NAME) (SIGNATURE OF PARTY OR ATTORNEY FOR PARTY) NOTICE  Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filedunder the Probate, Family, or Welfare and Institutions Code). (Cal. Rules of Court, rule 201.8) Failure to file may resultin sanctions. File this cover sheet in addition to any cover sheet required by local court rule.If this case is complex under rule 1800 et seq. of the California Rules of Court, you must serve a copy of this cover sheet on allother parties to the action or proceeding. Unless this is a complex case, this cover sheet shall be used for statistical purposes only. Page 1 of 2______________________________________________________________________________________________________________________________________________________________ Form adopted for Mandatory Use CIVIL CASE COVER SHEET Cal. Rules of Court, rules 201.8, 1800-1812;Judicial Council of California Standards of Judicial Administration, § 19CM-010 [Rev. January 1, 2006] www.courtinfo.ca.gov INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET To Plaintiffs and Others Filing First PapersIf you are filing a first paper (for example, a complaint) in a civil case, you must complete and file, along with your first paper, the Civil Case Cover Sheet contained on page 1. This information will be used to compile statistics about the types and numbers of cases filed. You must complete items 1 through 5 items on the sheet. In item 1, you must check one box for the case type that best describes the case. If the case fits both a general and a more specific type of case listed in item 1, check the more specific one. If the case has multiple causes of action, check the box that best indicates the primary cause of action. To assist you in completing the sheet, examples of the cases that belong under each case type in item 1 are provided below. A cover sheet must be filed only with your initial paper. You do not need to submit a cover sheet with amended papers. Failure to file a cover sheet with the first paper filed in a civil case may subject a party, its counsel, or both to sanctions under rules 201.8(c) and 227 of the California Rules of Court.To Parties in Complex CasesIn complex cases only, parties must also use the Civil Case Cover Sheet to designate whether the case is complex. If a plaintiff believes the case is complex under rule 1800 of the California Rules of Court, this must be indicated by completing the appropriate boxes in items 1 and 2. If a plaintiff designates a case as complex, the cover sheet must be served with the complaint on all parties to the action. A defendant may file and serve no later than the time of its first appearance a joinder in the plaintiff’s designation, a counter-designation that the case is not complex, or, if the plaintiff has made no designation, a designation that the case is complex. CASE TYPES AND EXAMPLES Auto Tort Contract Provisionally Complex Civil Auto (22)-Personal Injury/Property Breach of Contract/Warranty (06)Litigation (Cal. Rules of Court Rule Damage/Wrongful Death Breach of Rental/Lease 1800-1812) Uninsured Motorist (46) (if the Contract (not unlawful detainer Antitrust/Trade Regulation (03) case involves an uninsured or wrongful eviction) Construction Defect (10)motorist claim subject to Contract/Warranty Breach-Seller Claims Involving Mass Tort (40)arbitration, check this item Plaintiff (not fraud or negligence) Securities Litigation (28)instead of Auto) Negligent Breach of Contract/ Toxic tort/Environmental (30) Warranty Insurance Coverage Claims Other Breach of Contract/Warranty (arising from provisionally Other PI/PD/WD (Personal Injury/ Collections (e.g., money owed, open complex case type listed above)Property Damage/Wrongful Death) book accounts) (09) (41)Tort Collection Case – Seller Plaintiff Asbestos (04) Other Promissory Note/Collections Enforcement of Judgment Asbestos Property Damage Case Enforcement of Judgment (20)Asbestos Personal Injury/ Insurance Coverage (not provisionally Abstract of Judgment (Out of Wrongful Death complex) (18) County) Product Liability (not asbestos or Auto Subrogation Confession of Judgment (non- Toxic/environmental) (24) Other Coverage domestic relations) Medical Malpractice (45) Other Contract (37) Sister State Judgment Medical Malpractice - Contractual Fraud Administrative Agency Award Physicians & Surgeons Other Contract Dispute (not unpaid taxes) Other Professional Health Care Petition/Certification of Entry of Malpractice Real Property Judgment on Unpaid Tax Other PI/PD/WD (23) Eminent Domain/Inverse Other Enforcement of Judgment Premises Liability (e.g., slip Condemnation (14) Case and fall) Wrongful Conviction (33) Intentional Bodily Injury/PD/WD Other Real Property (e.g., quiet title)(26) Miscellaneous Civil Complaint (e.g., assault, vandalism) Writ of Possession of Real Property RICO (27) Intentional Infliction of Mortgage Foreclosure Other Complaint (not specified Emotional Distress Quiet Title above)(42) Negligent Infliction of Other Real Property (not eminent Declaratory Relief Only Emotional Distress domain, landlord/tenant, or Injunctive Relief Only (non- Other PI/PD/WD foreclosure) harassment) Mechanics Lien Non-PI/PD/WD (Other) Tort Unlawful Detainer Other Commercial Complaint Business Tort/Unfair Business Commercial (31) Case(non-tort/non-complex) Practice (07) Residential (32) Other Civil Complaint Civil Rights (e.g., discrimination, Drugs (38) (if the case involves illegal (non-tort/non-complex) False arrest) (not civil drugs, check this item; otherwise,harassment) (08) report as Commercial or Miscellaneous Civil Petition Defamation (e.g., slander, libel) Residential.) Partnership and Corporate (13) Governance (21) Fraud (16) Judicial Review Other Petition (not specified above)Intellectual Property (19) Asset Forfeiture (05) (43)Professional Negligence (25) Petition Re: Arbitration Award (11) Civil Harassment Legal Malpractice Writ of Mandate (02) Workplace ViolenceOther Professional Malpractice Writ – Administrative Mandamus Elder/Dependent Adult (not medical or legal) Writ – Mandamus on Limited Court Abuse Other Non-PI/PD/WD Tort (35) Case Matter Election Contest Writ – Other Limited Court Case Petition for Name Change Employment ReviewPetition for Relief from Late Wrongful Termination (36) Other Judicial Review (39) ClaimOther Employment (15) Review of Health Officer Order Other Civil Petition Notice of Appeal – Labor Commissioner Appeals CM-010 [Rev. January 1, 2006] CIVIL CASE COVER SHEET Page 2 of 2