Fill and Sign the Name Change Rc 271701 Southeastern Ohio Legal Form

H.C. FORM 21.1 – JUDGMENT ENTRY – CHANGE OF NAME MINOR 11/01/00 PROBATE COURT OF __________________ COUNTY, OHIO ____________, JUDGE IN RE: CHANGE OF NAME OF (Present Name)TO (Name Requested)CASE NO. APPLICATION FOR CHANGE OF NAME OF MINOR [R.C. 2717.01] The applicant states that the applicant is the parent legal guardian guardian ad litem of the minor and that the applicant has been a bona fide resident of County, Ohio, for at least one year prior to the filing of this application. A copy of the minor's birth certificate which was certified and shown to the Court is attached. The applicant states that the name and address of the mother of the minor is: Name Address Zip State Cityand the name and address of the father or alleged father of the minor is: Name Address Zip State City Applicant states that the address of the mother father or alleged father is unknown and cannot with reasonable diligence be ascertained. There is no person alleged to be the father of said minor. The applicant requests a change of name of the minor from to for the following reason: H.C. FORM 21.1 – JUDGMENT ENTRY – CHANGE OF NAME MINOR 11/01/00 The applicant states that the applicant will cause notice of the application to be published once in a newspaper of general circulation in this county at least thirty days before the hearing on this application. In addition, notice will be given by the applicant to any non-consenting parent or alleged father, whose addresses are known, by certified mail, return receipt requested. Attorney for Applicant Applicant's Signature Typed or Printed Name Typed or Printed Name Address Address City StateZip CityStateZip( ) ( ) Telephone Number (include area code) Telephone Number (include area code)Attorney Registration No.