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IN THE MATTER OF PETITION
FOR CHANGE OF NAME OF
KATELYN MARIE SMITH TO
KATELYN MARIE SULLIVAN
:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 98-1450 CIVIL TERM
AND NOW,
ORDER OF COURT
this tO~day of March, 1998,
upon consideration of
the Petition for Change of Name, it is ORDERED that a hearing on
Petitioner's request be held on Thursday, June 4, 1998, at 9:00
a.m., in Courtroom No.1, Cumberland County Courthouse, Carlisle,
Pennsylvania.
IT IS FURTHER ORDERED that notice of the filing of said
Petition and the aforesaid date, time and place of the hearing be
published once in the Cumberland Law Journal and a newspaper of
general circulation in the County at least 10 days prior to the
hearing~ in addition, Petitioners shall comply with all other
requirements of C.C.R.P. 5, and the Act of December 16, 1982, P.L.
1309, 56, and 54 Pa. C.S. 55701 et seq.
BY THE COURT,
/JJ~
J.
Mark C. Duffie, Esq.
301 Market Street
P.O. Box 109
Lemoyne, PA 17043-0109
Attorney for Petitioner
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010135-00002IMarch 9, 199B1MCDfPARl107251
, .
IN THE MATTER OF: PETITION
FOR CHANGE OF NAME OF
KATELYN MARIE SMITH TO
KATELYN MARIE SULLIVAN
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. q 9 - 1\/ (;0 c.~ "'G>~
The Petitioner, Becky M. Sullivan, through her undersigned counsel, requests that this Court order
a Change of Name pursuant to 54 PoSo ~ 701 et. seq" and In support thereof represents as follows:
1. Petitioner, Becky Mo Sullivan, Is a resident of Mechanlcsburg, Pennsylvania, and has resided
at the following locations during the five (5) years next preceding the filing of this Petition:
Residence ~ Cohabitants
5022 East Trindle Road 5/97 - Present Katelyn Marie Smith
Apartment B.6
Mechanlcsburg, PA 17055
209 Orchard Drive 12/96 - 5/97 Katelyn Marie Smith
Mechanlcsburg, PA 17055 Thomas L. Sullivan (father)
Lois A, Sullivan (mother)
3402 Honey Run Drive 5/96 - 12/96 Katelyn Marie Smith
York, PA WIlliam Dillen
William Dillen, Jr.
506 West Main Street 4/95 - 5/96 Katelyn Marie Smith
Mechanicsburg, PA 17055
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Tho Information apPoRrlng on tho certllled copy 01 birth Is oXBelly transcrlbod horn Information conlalned on tho orlglnol birth
certlllcale as flied with the Office 01 Vital Records.
If you wish 10 corroct tho certified copy Issued, pleaso complete tho lower porllon of this form In the presenco 01 a notarizing olllclel
and forward 10 tho DivisIon 01 Vllal Rocords, P.O. BOll 1528, Now Castle, Pa, '6103.
PlEASE SUBMIT DOCUMENTARY EVIDENCE TO SUPPORT THE CHANGES REOUESTED SL'CH AS A COPY OF A BAPTISMAL RECORD, EARLY
SCHOOL RECORD, MIUTARY RECORD, INSURANCE POLICY OR MARnlAGE LICENSE,
DATA
ORIGINAL RECORD NOW READS
CORRECTIONS DESIRED
(print full namos, datos. other)
NAME OF SUBJECT
DATE OF BIRTH
SEX
OTHER ERROR
OTHER ER~OR
FATHER'S SIGNATURE
SWORN AND SUBSCRIBED BEFORE ME
(NOTARY PUBLIC) THIS_.DAY OF
, 19
MOTHER'S SIGNATURE
SUBJECT'S SIGNATURE
PRESENT ADDRESS
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CUMBERLAND LAW JOURNAL
2 LIBERTY AVENUE
CARLISLE, PA 17013
JUNE 12, 1998
Cumberland Law Journal is published every Friday by the Cumberland County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal notices,
TO:
Mark C,Duffie, ESQUIRE
RE:
Katelyn Marie Smith to Katelyn Marie Sullivan
Legal advertisements must be received by Friday Noon. All legal advertising must be paid
in advance, Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on following dates:
Advertising Cost
$ 50.00
$ 0,00
$ 0,00
$ 0,00
..-----....-----
$ 50,00
JUNE 12, 1998
Proof of Publication
Second Proof Request
Payment received
Total Amount Due
Payment received
by
... PEtItIONER'S
.. EXHIBIT