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INRE:
CHANGE OF NAME OF
ADAM MICHAEL BOLTON
TO ADAM MICHAEL STONER
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 97- CIVIL TERM
CHANGE OF NAME
PETITION FOR CHANGE OF NAME
The petitioners, Debra L. Bolton and Donald E. Stoner, Jr., on behalf of their
minor son, Adam Michael Bolton, by and through their legal counsel, Landis, Black &
Schorpp, requests that this Honorable Court order a change of name for their son, Adam
Michael Bolton, pursuant to 54 Pa. C.S.A, ~ 701, at saq" and in support thereof
represents as follows:
1. Petitioner Debra L. Bolton is an adult individual principally residing at the
following location during the five years preceding the filing of this Petition: 464 West
Main Street, Walnut Bottom, Cumberland County, Pennsylvania 17266.
2. Petitioner Donald E. Stoner, Jr. is an adult individual principally residing at
the following location during the five years preceding the filing of this Petition: 119
South Park Avenue, Mercersburg, Franklin County, Pennsylvania 17236.
3. Adam Michael Bolton is a minor individual principally residing at the
following location during the five years preceding the filing of this Petition: 464 West
Main Street, Walnut Bottom, Cumberland County, Pennsylvania 17266,
4. Petitioners are both the natural parents of Adam Michael Bolton and both
have legal shared custody of him.
5. Adam Michael Bolton was born to Petitioners on March 21, 1991, at the
Chambersburg Hospital, Chambersburg, Pennsylvania, and is now six years of age. A
copy of Adam Michael Bolton's birth certificate is attached hereto as Exhibit "An.
6. The Petitioners, as Adam Michael Bolton's parents, desire to change his
name to Adam Michael Stoner.
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COtJHIY~
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F~ANKLlN
0,1,11 O't-fJ2-'1l
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DAn 07-30-9l
ISSUlo
It,I()(l"H,n,
SEX :~o\LE
AGE 26
AGE 20
5U,\.J EC T
ADAM ~ICHAEL UnLTO~
FATHERS NAME
OO~&LD EO~AR STONEK JK
MOIH~RS ~o\IOEN NAME
UE~qA LUANN SHUMAN
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',64 W MAIN RO
WALNUT HalTOM PA
l7266
Exhibit A