Fill and Sign the Indiana Name Change 497307094 Form

STATE OF INDIANA ) IN THE       CIRCUIT COURT ) SS: COUNTY OF       ) CASE NO.       IN RE CHANGE OF ) NAME OF MINOR: )       ) )       ) Petitioner. ) ORDER ON VERIFIED PETITION FOR CHANGE OF NAME OF MINOR Comes now the Court, having reviewed the Verified Petition for Change of Name of Minor and the Notice of Filing Proof of Publication, and having confirmed service on the non-petitioning parent now finds as follows: 1. The Minor Child’s current name is       . 2. The Minor Child resides at:             3. The Minor Child’s date of birth is       . 4. The Minor Child has not been convicted of a felony within the last ten (10) years. 5. The Petitioner wishes to change the Minor Child’s name to:       . 6. This Order is in accordance with the best interest of the Minor Child as guided by IC 31-17-2-8. WHEREFORE, IT IS ORDERED that Petitioner’s Petition for Change of Name of Minor is GRANTED , and Minor’s name is hereby changed to       .             Date Judge ____________ Circuit Court Distribution:       Print Your Name       Mailing Address       Town, State and Zip Code       Telephone Number, with Area Code Page 1 of 1 Form PS-34282-10 Approved by State Court Administration 12/10