Fill and Sign the Ny Change Form

SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF       IN THE MATTER OF THE APPLICATION OF: AFFIDAVIT OF DUE DILIGENCE       A Minor FOR LEAVE TO CHANGE HIS/HER NAME TO: INDEX NUMBER             The Affiant states under oath as follows: 1. That he she is the Parent Legal Guardian Next Friend of the Minor Petitioner in the above entitled action; 2. That the residence of the Father Mother of the Minor Petitioner, ______________________ (name) , is unknown to the Applicant; 3. That the Affiant has made a diligent search to find out the whereabouts of _____________________ , but the search has failed to reveal any information concerning his/her whereabouts or residence; 4. That the Affiant has contacted the persons listed in an attempt to find the location of : NAME ADDRESS a.             b.             c.             d.             5. The Affiant has taken the actions listed below as additional steps in an attempt to locating _____________________ , but was unsuccessful: a.       b.       c.       d.       1 6. That to the Affiant’s knowledge, the last known address of _____________________ was: ________________________________________________ as of : __________________ 7. That to the Affiant’s knowledge, _____________________ is not in the United States of America's Military Services; 8. And that this Affidavit is made for the purpose of enumerating to the Court the Affiant’s efforts to locate and give _____________________ Notice of this action for the Name Change of a Minor. Dated: ________________________ Affiant       Type or Print Name CERTIFICATE OF ACKNOWLEDGMENT Use Within the State of New York Use Outside the State of New York State of New York State of New York County of       County of       On ________________________ , before me, the undersigned, personally appeared       personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. On ________________________ , before me, the undersigned, personally appeared ______________________________ personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument and that such individual made such appearance before the undersigned in ________________________ (insert city or political subdivision and state or county or other place acknowledgment taken ) (signature and office of individual taking acknowledgment) (signature and office of individual taking acknowledgment)             Type or Print Name Type or Print Name 2