Fill and Sign the Order Name Change Form

State of Indiana County of ______________________________ In The ____________________________________________________________ Court In Re the Petition of:       )       )       )       )       )       ) CASE NO.       ) For a Change of Name to: ) )       )       )       )       )       )       ) ) ORDER FOR NAME CHANGE THIS matter came on for hearing on a Petition to Change Name filed by Petitioner and the court after having considered said Petition finds as fact as follows: 1. That this Court has jurisdiction of the parties and subject matter and venue is proper. 2. That the Petitioners are of full legal age and is a bona fide resident of the County of ________________________ , State of Indiana, whose residence address is ____________________________________________________________ . Petitioners have been a bona fide resident of ________________________ County, State of Indiana for ______ years immediately prior to filing this Petition. Petitioner was born on the ______ day of ____________ , ______ , in the County of ________________________ , State of ________________________ . 3. Petitioners’ and minors present names are as follows. These are the current names of Petitioners and minor children on their social security cards and all other records. - 1 - Name:       Age:       Address:                   Name:       Age:       Address:                   Name:       Age:       Address:                   Name:       Age:       Address:                   4. That the Petitioner(s) pray for the change of names for the following reasons: (describe in detail): ____________________________________________________________ ____________________________________________________________ 5. That the proposed change in the Petitioner’s name will not be detrimental to the interests of any other person and is not against the public interest. 6. That Petitioner is not confined to a department of correction facility. This Petition is not filed to defraud creditors. 7. Petitioner(s) are (check one) not married or is married to ________________________ . 8. Petitioner(s) (check one) owns no real estate or owns real estate in ________________________ County, ________________________ . - 2 - 9. Petitioner(s) have met the publication requirements and have filed the pertinent affidavit with regard to certification of publication. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED, that the names of the said PETITIONERS and minor children are hereby changed as follows, and Petitioners are hereby authorized to hereafter use said name as a legal name; and that such change shall be made and entered herein as record of this Court: From To                                                             DATED this ______ day of ________________________ , 20 ______ . BY THE COURT: ____________________________ CIRCUIT COURT JUDGE Prepared and Presented by:                         - 3 - State of Indiana County of ______________________________ In The ____________________________________________________________ Court In Re the Petition of:       )       )       )       )       )       ) CASE NO.       ) For a Change of Name to: ) )       )       )       )       )       )       ) ) ORDER FOR HEARING NOW on this the ______ day of ____________ , 20 ______ , the Court finds that the Petition filed by ______________________________ and ______________________________ in the above captioned matter should be heard on the ______ day of ____________ , 20 ______ , at ______ o'clock a.m. in this Court. __________________________________ Circuit Court Judge Submitted By:       Petitioner       Petitioner - 1 -