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Fill and Sign the Change Name Minor 481379805 Form

Fill and Sign the Change Name Minor 481379805 Form

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Commonwealth of Massachusetts The Trial Court Probate and Family Court Department ____________ Division Docket No. In the Matter of the Petition of: __________________________________ For a Change of Name t o: __________________________________ CONSENT CHANGE OF NAME I, ______________________________, the Mother Father Step-father Guardian of the above-referenced minor child(ren), do here by give my full and free consent to change (name of first child) _____ ___________________’s name to (name you want the first child to have) _______ _________________. I also give my full and f ree consent to change (second child’s name -if no second child, write “N/A”) ________________________ ’s name to (name you want the second child to have or “N/A”) ________________________. I request that the relief req uested in the Application for Change of Name on file be granted. DATED this (day) ______ day of (month) ____________, (year)_ _____. ____________________________________ (signature) State of Massachusetts County of __________________ The foregoing instrument was acknowledged before me this _ _____ day of ____________, 20______, by ________________________ ______ (person). ________________________________ NOTARY PUBLIC Print Name: My Commission Expires: ____________

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