Fill and Sign the New Jersey Name Change 497319460 Form

JOHN LAWYER, ESQ. 12 MAIN STREET ANYWHERE, USA ---------------------------------------------------X SUPERIOR COURT NEW JERSEY In the matter of the application of: [insert] COUNTY LAW DIVISION JOHN SMITH, for leave to assume the name of JOHN DOE DOCKET NO.: COMPLAINT ----------------------------------------------------X John Smith residing at [insert address] by way of complaint say: 1. Plaintiff was born on [insert date of birth], at [insert hospital and place]. 2. The plaintiff is a citizen of the United States of America. 3. 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. 4. No previous application has ever been made by the plaintiff or infant for leave to assume another name. 5. The reason for this application is plaintiff = s desire to assume the last name of his stepfather, A [insert] @ . 7. This application is not made with the intent to avoid creditors or to obstruct criminal prosecution or for other fraudulent purposes. 8. Plaintiff has ever been convicted of a crime. 9. No criminal charges are pending against any plaintiff. WHEREFORE, plaintiffs demand judgment pursuant to [insert statute] et seq.: Authorizing John Smith to assume the name of John Doe. DESIGNATION OF TRIAL COUNSEL John Lawyer, 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 Dated: