Fill and Sign the Fillable Online Sos Ri What is a Universal Appointment Bond Form

PC-8.1 (11/02, formerly SW-19) Change of Name Date filed: _____________________ Court use only STATE OF RHODE ISLAND County of ___________________________________ PROBATE COURT OF THE Estate of ____________________________________ _________________________________________________ Alias _______________________________________ Alias _______________________________________ No. ____________________ ____________________ Date CHANGE OF NAME The undersigned petitioner requests the following name change: [ ] self [ ] for minor child __________________________________________________________________________ Curre n t N am e __________________________________________________________________________ No. Street __________________________________________________________________________ Cit y/T own State Zip Phone Num ber __________________________________________________________________________ Mailing Address (if different) No. Street __________________________________________________________________________ Mailing Add ress (if di ff e rent) Cit y/Town State Zip Name on Original Birth Record: _____________________________________________________ Date of Birth: __________________________ Place of Birth: __________________________ Mother’s Maiden Name: ____________________ Father’s Name: ____________________ Petitioner’s Occupation: ____________________________________________________________ Petitioner’s Marital Status (optional) : ____________________________________________________ The petitioner resided at the following addresses: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Reason for name change (be specific): _________________________________________________ Petitioner requests a name change to: __________________________________________________ If applicable, the name on the birth record should be changed to: ________________________________________________________________________________ (continued on page 2) PC-8.1 (11/02, formerly SW-19) If minor: _______________________________________________ _______________________________________________ Father Signature Mother Signature Attach form PC—9.1, Waiver, if applicable. The undersigned petitioner makes affidavit and says that the above facts are true as to the best of his/her knowledge an d belief. __________________________________________ __________________________________________ Signature of petitioner Date _____________________________________________________ Relationship of petitioner _____________________________________________ Sc. Subscribed and sworn to before me as to the truth of all of the above facts by the petition er. __________________________________________ __________________________________________ Notary public (please print name) Notary public signature DECREE Upon hearing, it is here by ordered and decreed: _______________________________________________ _______________________________________________ Date Probate Judge Attach certified copy of the origin al birth certificate and BCI Report.