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Fill and Sign the Name Change Adult 497324106 Form

Fill and Sign the Name Change Adult 497324106 Form

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IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR __________ COUNTY PROBATE DEPARTMENT In the Matter of the Change of Name of: ) )       ) Case No.: ____________ (Present Name of Petitioner) ) ) AFFIDAVIT-PROOF OF POSTING ) NOTICE OF HEARING To: ) )       ) (Proposed New Name) ) State of Oregon ) County of __________ ) I,       being first duly sworn, do hereby declare: Your Present Name I posted the Notice of Name Change Hearing on the ________________ County Courthouse Bulletin Board, where it remained posted for the number of days required by law, beginning on __________________ , 20 ____ , and ending on ______________ , 20 ______ . Date Notice Posted Today’s Date The Notice of Name Change Hearing provided written notice of my Petition to change my name and included the date, time, and location and subject of the Hearing. The Bulletin Board where the notice was posted is located on the second floor of the ____________ County Courthouse, in Room ____ , at the following address: ________________________ . ________________________________ Petitioner’s Signature (Present Name) Subscribed and sworn to before me this ________ day of _________________ , 20 ____ . ________________________________ Court Clerk/Notary Public for Oregon My commission expires: ___________

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