Fill and Sign the Name Change Application Form

JOHN LAWYER, ESQ. 12 MAIN STREET ANYWHERE, USA Attorneys for John Doe _____________________________ In the matter of the application of: JOHN DOE for leave to assume the name of JAMES DOE ______________________________ SUPERIOR COURT OF NEW JERSEY [INSERT] COUNTY:LAW DIVISION DOCKET NO. CIVIL ACTION VERIFIED COMPLAINT JOHN DOE residing at [insert] in the Township of [insert], County of [insert] and State of [insert] by way of complaint says: Plaintiff was born on [insert date], at [insert] Hospital, [insert Town], [insert County]. The plaintiff is a citizen of the United States of America. No judgments have ever been recovered against the plaintiff, no bankruptcy or insolvency proceedings have ever been instituted affecting plaintiff; no suits are now pending against him. No previous application has ever been made by the plaintiff for leave to assume another name. The reason for this application is because [insert reason for name change]. This application is not made with the intent to avoid creditors or to obstruct criminal prosecution or for other fraudulent purposes. Plaintiff has never been convicted of a crime. No criminal charges are pending against any plaintiff. WHEREFORE, plaintiff demand judgment pursuant to N.J.S.A. 2A:52-1 et seq.: authorizing [insert] to assume the name of [insert]. DESIGNATION OF TRIAL COUNSEL [insert], Esq., is hereby designated as trial counsel in this matter. CERTIFICATION I hereby certify pursuant to Rule 4:5-1 that this matter is not the subject of any other action pending in any Court or of a pending arbitration proceeding, and that there exist no other parties to be joined to this action. JOHN LAWYER, ESQ. BY:______________________________ Dated: