Fill and Sign the Form 15 Notice of Intention to Resume Prior Surname

Divorce Form 15 Notice to Resume Prior Surname Notice of Int ention to Resume Prior Surname Form 15 Divorce Form 15 Notice to Resume Prior Surname AOPC 7.1.14 Form 15 - Notice of Intention to Resume Prior Surname The numbers on these instructions correspond with the numbers in the boxes on the form. Use the form with the boxes to guide you through filling out the blank form. Box 1: Print the name of the county in which you filed exactly as it appears on Form 1. Box 2: Print the name of the Plainti ff exactly as it appears on Form 1. Box 3: Print the docket that the Prothonotar y's Office wrote on Form 1 at the time of filing. B ox 4: Print the name of the Defendant exactly as it appears on Form 1. B ox 5: Print your current full name. B ox 6: Print either “Plaintiff” or “ Defendant.” (If you filed the original Divorc e Complaint, then you are the Plaintiff. If you did not file the original Divorce Complaint then you are the Defendant). B ox 7: Check the date the Divorce Complaint was filed or the date a Divorce Decree was granted. Box 9: Print the date the Divorce Decree was granted. Box 10: Print the surname (last name) of the name you wish to resume. Box 11: Print the date you sign the document. Box 12: Sign your current name. B ox 13: Sign the name you are resuming. Box 14: Write your spouse's name by arrowbox 3. Write your spouse's name exactly as you wrote it on Form 1, by arrowbox 3. IF YOUR COUNTY REQUIRES THIS FORM BE NOTARIZED, DO NOT SIGN THIS FORM UNTIL YOU ARE IN FRONT OF A NOTARY PUBLIC .Box 8: Print the date the Divorce Complaint was filed. Box 14: Print the name of the county you are filing in exactly as you wrote in on Form 1. Box 15: Print your name exactly as you wrote it on Form 1. OR Divorce Form 15 Notice to Resume Prior Surname AOPC 7.1.14 Box 16: Print the docket number. The docket number is the number that the Prothonotary's Office wrote on Form 1, at the time of filing. Box 17: Print your spouse's name exactly as you wrote in on Form 1. The Notary Public will complete the rest of t his f orm. Divorce Form 15 Notice to Resume Prior Surname AOPC 7 .1.14 1 IN TH E CO URT OF C OMMON PLEAS OF COUNTY , PE NN SYLVA NIA CIVIL ACTION 2 , : PLAI NTIFF : 3 : : Case No. 4 vs. : : , : DEFEN DANT : IN DIVORCE NOTICE OF INTENTION T O RESUME PRIOR SURNA ME Pu rsuan t to Title 54 P.S . 704 5 NOTICE is here by given that I, , t he (Plaintiff o r De fendant) in the above- ca ptioned case in which a: , orComplaint in Divorce was filed on: . 10 here by elect to resu me the prior surn ame of 11 Da te: 12 Signature using y our curren t na me 13 Signature using na me being resu med 6 7 8 9 Decree in Divorce was filed on: 7 Divorce Form 15 Notice to Resume Prior Surname AOPC 7 .1.14 14 IN THE COURT OF COMMON PLEAS OF_ COUNTY , PENNSYLVANIA , : PLAI NTIFF : 16 : : Case No . vs. : : , : DEFEN DANT : IN DIVORCE COMMONWEALTH OF PENNSYLVANIA COUNTY OF On thi s, the day of _, 20 , pe rsona lly appeared before me, a Nota ry Public in and for sa id Co mm onweal th an d County, (f ul l ma rried na me ), k nown to me (o r s ati sfac toril y pro ven) to be the person who is the pe rson whose name is s ubscribed to the wit hin docum ent and acknowledg ed tha t s he exec uted the same for th e purposes t herei n c ontained. No tary Publi c: My Comm iss ion Ex pires: 15 17 Divorce Form 15 Notice to Resume Prior Surname AOPC 7.1.14 IN THE COURT OF COMMON PLEAS OF_________________ COUNTY, PENNSYLVANIA CIVIL ACTION _______________________________, : PLAINTIFF : : : Case No. ______________ vs. : : _______________________________, : DEFENDANT : IN DIVORCE NOTICE OF INTENTION TO RESUME PRI OR SURNAME P ursuant to Title 54 P.S. 704 NOTICE is hereby given that I, _ _______________________________ , the __________________________ (Plaintiff or Defendant) in the above- captioned case in which a: Complaint in Divorce was filed on: ___________________, or Decree in Divorce was granted on: ___________________. hereby elect to resume the prior surname of _____________________________ Date: _________________ ________________________________ Si gnature using your curr ent name ________________________________ Signature using name being resumed Divorce Form 15 Notice to Resume Prior Surname AOPC 7.1.14 IN THE COURT OF COMMON PLEAS OF__________________ COUNTY, PENNSYLVANIA _______________________________, : PLAINTIFF : : :Case No. ______________ vs. : : _______________________________, : DEFENDANT : IN DIVORCE COMMONWEALTH O F PENNSYLVANIA COUNTY OF _______________ _________ On this, the _______ day of ___________________________, 20_____, personally appeared before me, a Notary Public in and for said Commonwealth and County, ________________________________________ (full married name), known to me (or satisfactorily proven) to be the person who is the person whose name is subscribed to the within document and acknowledged that she executed the same for the purposes therein contained. Notary Public: My Commission E xpires: