Fill and Sign the Change Name Adult 497431196 Form

PRINT in INK Enter the name of the county in which this case was filed. STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Enter the current name of the person whose name is proposed to be changed. In the matter of the name change of:       First Name MiddleName Last Name Enter the case number. Amended Order for Name Change Case No.       The petition for name change was heard by the Circuit Court of       County, Wisconsin on the       day of       , 20       . THE COURT FINDS: 1. The person whose name is to be changed lives in       County, State of Wisconsin. 2. The name that appears on the birth certificate is (First, Middle, Last Name)       . 3. The address of the person whose name is to be changed is       . 4. The date of birth of the person whose name is to be changed is       . 5. It has jurisdiction and notice of the hearing has been given. 6. The facts of the petition are true and correct. 7. Other:       THE COURT ORDERS: 1. The Petition for Name Change is granted. 2. The name of this person shall be changed to (First, Middle, Last Name)       . 3. If the person was born in Wisconsin, the Wisconsin birth certificate shall shall not be changed. 4. Other:       THIS IS A FINAL JUDGMENT/ORDER FOR PURPOSES OF APPEAL. For Court Use Only. BY THE COURT : Circuit Court Judge       Print or Type Name       Date CV-470, 09/13 Order for Name Change §786.36, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional materials.Enter the county and the date of the hearing. STOP! The court will complete the rest of this form.In 1, enter the county name. In 2, enter the name as it appears on the birth certificate. In 3, enter the address. In 4, enter the date of birth.