Fill and Sign the Date Hearing Change Form

      Name       Street Address       City, State, Zip       Telephone Number In the Matter of the Application of:       Your Name To Change the Name of:       Name of Minor Child (first, middle, last) To:       Name you wish your child to assume Superior Court Of New Jersey Law Division       County Docket No.       (To be filled in by the court) CIVIL ACTION Order Fixing Date of Hearing Application be made to the Court by       , (your name, first, middle, last) for a judgment authorizing (check one) his her minor child to assume another name and for the entry of an order fixing a date for the hearing of such application, DO NOT WRITE BELOW THIS LINE THE COURT WILL COMPLETE IT IS ON THIS       day of       , 20       , ORDERED that the       day of       , 20       , at       a.m., or as soon thereafter as the matter may be heard, at the courthouse in the City of       , County of       , State of New Jersey, be fixed as the time and place for the hearing of such application and of any objections that may be made thereto. IT IS FURTHER ORDERED that a notice of such application be published in       once, at least two (2) weeks preceding the date set for the hearing. J.S.C. NOTE: Copies of the verified complaint and order fixing the date of the hearing must be sent to the parent of the minor child via regular mail and certified mail to the newspaper for publication and served on the County Prosecutor if the minor has criminal charges pending. Revised11/17/2014, CN 10551 - Name Change (Minor), Form B Page 1 of 1