Fill and Sign the Petitionerguardian Ad Litem Form

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR __________ COUNTY PROBATE DEPARTMENT In the Matter of the Change of Name of: ) ) ) Case No.: ____________ ) ) ) ) ) PETITION FOR CHANGE ) OF NAME (Present Name(s) of Minor Child/ren) ) ) To: ) ) ) ) ) ) ) ) ) (Proposed Name(s) of Minor Child/ren) ) ) ) ) (Petitioner/Guardian Ad Litem) ) A. I, petitioner, am the ____________________ (describe relationship) of the child/ren named in this petition. The date(s) of birth of the child/ren is/are: ________ ____________________________________________________________________ (fill in name and date of birth of each child). B. I request a decree changing the name(s) of the child/ren as set forth in the title of this petition.C. I am 18 years old or older. The child/ren reside(s) in __________ County. D. I am requesting this name change because: ___________________________________ ____________________________________________________________________ ____________________________________________________________________ E. (Check the box that applies): Both parents of the child/ren are living. OR The ____________________ (mother, father, or parents) of _______________ (name(s) of child/ren) is/are deceased. F. (Check the box that applies): The child/ren does/do not have any legal guardian other than his/her/their parents. OR The legal guardian(s) of ___________________________ (name(s) of child/ren) is/are ___________________________ (name(s) of guardian(s)). G. I am not one of the parents of the child/ren. I request that I be appointed Guardian Ad Litem for the child/ren in this proceeding. _______________________________ Petitioner/Guardian Ad Litem STATE OF OREGON ) ) ss. County of _______________ ) I, ___________________, being first duly sworn, do hereby declare and say that I am the petitioner in this case; I have read this petition and know its contents, and I believe it to be true. _______________________________ Petitioner SIGNED AND SWORN to before me on ___________________. _______________________________________ Court Clerk/Notary Public for the State of Oregon My commission expires: ______________ Submitted by: Attorney/Petitioner’s Name Bar No. (if any) Address City State Zip Phone No. Trial Attorney if other than above Bar No. Certificate of Document Preparation If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all boxes and complete all blanks that apply) A. I selected this document for myself, and I completed it without paid assistance. B. I paid or will pay money to _________________ for assistance in preparing this form/document __________________________ Signature