Fill and Sign the Wi Name Change Form

PRINT in INK Enter the name of the county in which this case was filed. STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Enter the current name of the person whose name is proposed to be changed. In the matter of the name change of:       First Name MiddleName Last Name Enter the case number. Amended Order Denying Name Change (30708 ) Case No.       The petition for name change was heard by the Circuit Court of       County, Wisconsin on the       day of       , 20       . IT IS ORDERED that the petition is DENIED because: (check all that apply) 1. The person whose name is requested to be changed is required to register as a sex offender and is prohibited from changing his/her name pursuant to law. 2. The person whose name is requested to be changed is engaged in a licensed profession and has not obtained the approval of the applicable licensing board or commission. 3. The petitioning parent has failed to: personally serve the non-petitioning parent. show that he/she made a reasonable attempt to personally serve the non- petitioning parent, but was unable to do so. 4. The non-petitioning parent appeared at the hearing, showed that he/she has not abandoned or failed to assume parental responsibility for the child, and objects to the requested name change. 5. Other:       THIS IS A FINAL JUDGMENT/ORDER FOR PURPOSES OF APPEAL. For Court Use Only. BY THE COURT : Circuit Court Judge       Print or Type Name       Date CV-475, 01/09 Order Denying Name Change §786.36, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional materials. Page 1 of 1Enter the county and the date of the hearing. Check all that apply. If other, explain.