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IN THE MATTER OF PETITION
FOR CHANGE OF NAME OF
BREANNA DENISE BEAVER
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY
: PENNSYLVANIA
: No. - 2001- :315'3 c...:M -r:u--
PETITION FOR CHANGE OF NAME
The Petitioners, Daniel C. Beaver and Jennifer F. Beaver, husband and wife,
on behalf of their minor child, Breanna Denise Beaver, hereby request that this
Court order a change of name of said minor child pursuant to 54 Pa.C.S.A. ~701
et.seq., and in support thereof represent the following:
1. Petitioners, Daniel C. Beaver and Jennifer F. Beaver, are the adoptive parents of
the mimlr child, Breanna Denise Beaver, who is the subject of this Petition for
change of name.
2. Petitioners and the child reside at 28 West Marble Street, Mechanicsburg, PA
17055. The Petitioners and the child have resided at the following locations
during the five (5) years immediately preceding the filing of this Petition (i.e.
from 1996 to the present):
From 12/94-11/97, Petitioners resided at: 6601 Maple Drive
Clarkston, MI 48346
From 11/97-12/98, Petitioners resided at: 8501 Thomas Avenue
Bloomington, MN 55431
From 12/98-present, Petitioners and children reside at: 28 W. Marble Street
Mechanicsburg, PA 17055
3. The Petitioners adopted the child at age Three (3), in 1998, through the Court of
Common Pleas of Hennepin County, Minnesota. At the time of the adoption, the
child's name was changed to BreannR Denise Beaver.
4. The child, Breanna Denise Beaver, desires to change her name to Hannah
Denise Beaver.
5. The Petitioners are in complete agreement with the child's desire to change her
name.
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WHEREFORE, Petitioners respectfully request that this Court enter a
decree changing the child's name from Breanna Denise Beaver to Hannah Denise
Beaver.
BALL, MURREN & CONNELL
BY:
C~'M(~
Teresa R. McCormack
2303 Market Street
Camp Hill, PA 17011
(717) 232-8731
Date: S-'J-?--o I
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VERIFICATION
I, Daniel C. Beaver, Petitioner herein and adoptive father of the minor child,
Breanna Denise Beaver, hereby verify that the statements made in the foregoing
document are true and correct to the best of my knowledge, information and belief.
Date:
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Daniel C. Beaver
Sworn to and subscribed
to me this ~day of
May, 200l.
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Notary Public
NolarialSeal
Tara D. Haubert. Notary Public
S"verSpringlWp.;l.~!I:'!I~riand County
My Commis8lon """"""June 14, 2004
Member, PenrisYl\i8nla ASSOCIatton ot Notaries
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VERIFICATION
I, Jennifer F. Beaver, Petitioner herein and adoptive mother of the minor
child, Breanna Denise Beaver, hereby verify that the statements made in the
foregoing document are true and correct to the best of my knowledge, information
and belief.
Date:
?!r1YU~A ~!L&LJ0)
Jen er F. Beaver
Sworn to and subscribed
to me this J2thday of
May, 200l.
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Notary Public
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NotarialSeal
Tara D. Haubert, Nolary Publlo
Silver SpringlWp. Cumberland County
My Commission E'XPiresJune14, 2004
Member, PennsylVania AssooIation of Notaries
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IN THE MATTER OF PETITION
FOR CHANGE OF NAME OF
BREANNA DENISE BEAVER
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY
: PENNSYLVANIA
: No. -2001-)IS.3 Ciuil y~
ORDER
. AND NOW, th'" J I S~'" of A:lA of , 2001'Jl~'i''l7 "d'ffld that a
hearing on the Petition for Change of Name is fixed for . , 2001, at
9:dd o'clock, in Courtroom No..L, of the Cumberlan County Courthouse,
Carlisle, Pennsylvania. ~, "A Y A. 111.
The Petitioners are directed to give notice ofthe filing ofthe Petition and of
the date of the hearing thereon by publication, once in the Carlisle Sentinel and
once in the Cumberland Law Journal.
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IN THE MATTER OF PETITION
FOR CHANGE OF NAME OF
BREANNA DENISE BEAVER
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY
: PENNSYLVANIA
: No. - 2001 _ 3/S3 Ciu:J-r.t---
ORDER
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AND NOW, this JfI day of ,2001, upon consideration of the
Petition for Change of Name filed by the Petitioners, Daniel and Jennifer Beaver,
on behalf of their minor child, Breanna Denise Beaver, and upon proof of
publication of notice as required by law, and it appearing that there is no lawful
objection to the request of the Petitioners,
It is hereby ORDERED that the name of the minor child, Breanna Denise
Beaver, is changed to Hannah Denise Beaver.
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IN THE MATTER OF PETITION
FOR CHANGE OF NAME OF
BREANNA DENISE BEAVER
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY
: PENNSYLVANIA
: No. 3153 - 2001
AFFIDAVIT OF PUBLICATION
I, TERESA ROOS MCCORMACK, ESQ., counsel for the Petitioners, being
duly sworn according to law, hereby aver the following:
1. Notice of the filing of the Petition for Change of Name in the above-referenced
matter, and of the date of the Hearing thereon, was published in the
Cumberland Law Journal on June 15, 2001. A copy of the Notice and of the
Proof of Publication is attached hereto as Exhibit 1.
2. Notice ofthe filing ofthe Petition for Change of Name in the above-referenced
matter, and of the date of the Hearing thereon, was published in the Carlisle
Sentinel on June 8, 2001. A copy ofthe Notice and of the Proof of Publication is
attached hereto as Exhibit 2.
BALL, MURREN & CONNELL
BY:~~'~~
Teresa R. McCormack, Esq.
2303 Market Street
Camp Hill, PA 17011
(717) 232-8731
LD. #57310
Attorney for Petitioners
Sworn to and subscribed
before me this ,j I ~r day of
A~t, 2001. ~ .
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ota lrPublic
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. NOTARIAl. SEAl
GlORIA J. COPPERSMITH, Notary NlIic
Camp Hm Bolo, C\lnlberland County
My 0001ll1ies1on ExpIres JUIltl21, 2003
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PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16,1929), P. L.1784
STATE OF PENNSYLVANIA :
ss.
COUNTY OF CUMBERLAND :
Roger M. Morgenthal, Esquire, Editor ofthe Cumberland Law Journal, ofthe County
and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland
Law Journal, a legal periodical published in the Borough of Carlisle in the County and State
aforesaid, was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues ofthe said Cumberland Law
Journal on the following dates,
Viz
JUNE 15,2001
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that-all allegations in the foregoing
statements as to time, place and character of publication are
/
RJger M. Morgenthal, Editor
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SWORN TO AND SUBSCRIBED before me this
15 day of JUNE. 2001
NOli .
LOIS E. ~PuIlIIc
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CUMBERLAND LAW JOURNAL
NOTICE
In the Court of Common Pleas of
Cumberland County Pennsylvania
No. 2001-3153 Civil Term
PETITION FOR
CHANGE OF NAME
NOTICE
NOTICE IS HEREBY GIVEN that.
on May 24, 2001, the Petition of
Daniel Md Jennifer Beaver. on be-
half of thetr IIIinor chUd. Breanna De-
nise Beaver. was filed in the above
named court, requesting a decree to
change her name from Brearma De-
ruse Beflver to Hannah Denise Bea-
ver.
The Court has fixed August 24.
2001, 111 Courtroom No.5 at 9:00
A.M.. cumberland County Court-
house. One Courthouse Square, Car-
lisle. PA. as the time and place for
the hearing on said petition. when
and where all interested parties may
appear iUld show cause, If any they
have. why the prayer of the said
Petition should not be granted.
'IERJ!;SA R. McCORMACK,
ESgUlRE
BALI.. MURREN & CONNELL
2302 Market Street
Camp Hill, PA 17011
June 15
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PROOF Of Pl~BLlCATION
State of Pennsylvania,
County of Cumberland.
Sherry Clifford, Classified Ad Manager of THE SENTINEL,
of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of
general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th,
1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice
or publication attached hereto is exactly the same as was printed and published in the regular editions and
issues of THE SENTINEL on the following dates, viz
Copy of Notice of Publication
IN THE COURT OF
COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA,
No. 2001-3155
CIVIL TERM
,P'ETITJON FOR CHANGE
OF NAME
NOTICE
NOTICE IS HEREBY GIV-
.,::EN thaCon May 24,
'" 2001, the Petition of
, ...,DatlielandJenniferBea.
, ... Ye't';'ori behalf of their
minor child, Brenna
Denise Beaver, was
filed in the above named
, , c;:-ourt, requesting a
. . decree to change her
name from Brenna
Denise Beaver to
" ..,Hannah Denise
.... Beaver.
The Court has fixed August
. 24,2001, in Courtroom
No 5 at 9:00 AM,
Cumberland County
. CQurthouse, One "' _
Courthouse Square,
Carlisle, PA, as the time
, and place for the hearing'
on said petition, when
and where all interested
parti'es may appear and
, show cause, jf any they
,~ave" why the prayer of
the said Petition should
not be granted.
.Teresa R. McCormack,
Esquire'
BaH, Murren & Connell
2302 Market Street ..
Camp Hill, PA 170i 1 .
June 8, 2001
Affiant further deposes that he is not interested in
the subject matter of the aforesaid notice or
advertisement, and that all allegations in the
foregoing statement as to time, place and character
of publication are true.
I
June 14, 2001
Sworn to and subscribed before me this
day of June , 2001.
O.~
14th
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Notary Public
My commission expires:
NOTARIAL SEAL
SHIRLEY O. DURNIN, Notary Public
Car"sle Bora.. Cumberland County
M Commission Expires Au . 9, 2003
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IN THE MATTER OF PETITION
FOR CHANGE OF NAME OF
BREANNA DENISE BEAVER
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY
: PENNSYLVANIA
: No. 3153 - 2001 Civil Term
AMENDED ORDER OF COURT
AND NOW, this (, ~ day of December, 2001, upon consideration ofthe
Petition for the Change of Name, filed by the Petitioners, Daniel and Jennifer
Beaver, on behalf of their minor child, Breanna Denise Beaver, and upon proof of
publication of notice as required by law, and it appearing that there is no lawful
objection to the request of the Petitioners,
It is hereby ORDERED that the name of the minor child, Breanna Denise
Beaver, is changed to HANNAH DENISE BEAVER.
FURTHER, the registrar is directed to change the birth record to reflect this
change of name, pursuant to Chapter 4601 ofthe rules of the Minnesota
Department of Health.
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Protecting, maintaining and improving the health of all Minnesotans
November 21,2001
Ms. Teresa R. McCormick
Ball, Murren & Connell
2303 Market Street
Camp Hill, Pennsylvania 17011
Dear Ms. McCormick:
I have received your request to amend your client's birth record. Minnesota Department of
Health Rules governing birth records require additional documents to complete your request.
Please find your original documents enclosed along with a checklist indicating the required
documents and/or information needed to complete this amendment.
Please return only the documents and/or information requested on the checklist to the address on
the bottom ofthe checklist. Please feel free to contact me at 612-676-5128 if you have any
questions or concerns.
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Records Management
Center for Health Statistics
P.O. Box 9441
Minneapolis, MN 55440-9441
KWJ:
Enclosures
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General Information: (651) 215.5800 . TDD/TTY: (651) 215-8980 . Minnesota Relay Service: (800) 627-3529 . www.health.state.mn.us
For directions to any of the MDH locations, call (651) 215-5800 . An equal opportunity employer
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CHECKLIST FOR APPLICATION TO AMEND A BIRTH RECORD or
LEGAL CHANGE OF NAME COURT ORDE:R
for BREANA DENISE BEAVER 03728995
o $20.00 fee for amending a birth record.
o $13.00 fee to issue a certified copy of the birth record. Additional copies ordered at the same time are
$7.00. (If desired) Please complete the enclosed application for a birth record and sign in front of a
notary public. This must be completed before ANY birth record will be issued.
. Or .
o If you have a certified copy of the birth record issued within the last year, please retum it. The certificate
will be reissued at no charge. Please complete the enclosed application for a birth record and sign in
front of a notary public. This must be completed before ANY birth record will be issued.
. 'Or .
o If you have a certified copy of the birth record issued more than one year ago, please return it. The
certificate will be reissued for $5.00. Please complete the enclosed application for a birth record and
sign in front of a notary public. This must be completed before ANY birth record will be issued.
o Make check or money order payable to Treasurer, State of Minnesota (Fees are eurreat as or November 21, 2001)
o The following information is needed to assist you:
Full Name at Birth: Date of Birth:
City & County of Birth Parents' Full Names:
o If the registrant is 18 years of age or older, complete the Application to Amend Birth Record form
enclosed including The Record Shows" and "The Correct Information Is".
D If under 18 years of age - Parent, Guardian or Legal Representative must complete the enclosed
Application to Amend Birth Record including The Record Shows" and "The Correct Information Is".
D Sign, complete address and phone number in presence of Notary Public. Notary Public must date, sign
and place their seal on the Application to Amend Birth Record .
D Obtain document(s ) from the enclosed Requirements for Documents Submitted to
Support the Amendment of a Birth Record form. The document(s) will be returned to you.
[!] A certified copy of the Name Change Court Order showing a signature and raised seal is required to
amend the birth record. The court order must direct tbe registrar to change the birth record.
~ Any questions regarding above, call our office at 612-676-5128.
I Xl Comments: Under Minnestoa Department of Health Rnles Chapter 4601, to use a court order to amend
a birth record the court order must specifically direct the birth record to to be amended. This court
order does not specifically direct the birth record to be amended and can not be used to amend your
client's birth record
Please return all requested documents, fees and this form to the following address:
Minnesota Department of Health
Center for Health Statistics
Attn: Records Management Unit - K. Jeppesen
717 Delaware St. S.E. - P. O. Box 9441
Minneapolis, MN 55440-9441
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LAw OFFICES
BALL, MURREN & CONNELL
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DEC 7 - L.:n1
2303 MARKET STREET
CAMP HILL, PENNSYLVANIA 17011
PHILIP J. MURREN
RICHARD E. CONNELL
MAURA K. QUINLAN
TERESA R. MCCORMACK
THOMAS A. CAPPER
(717)232-8731
FACSIMILE (717) 232-2142
WILLIAM BENTLEY BALL
(1916-1999)
MAILING ADDRESS:
P.O. BOX 1108
HAmuSBURG, PENNSYLVANIA 17108-1108
December 6, 2001
The Honorable Edward E. Guido
Cumberland County Court
of Common Pleas
1 Court House Square
Carlisle,PA 17013
Re: Petition for Change of Name of Breanna Denise Beaver
No. 2001-3153 Civil Term
Dear Judge Guido:
As a result of a hearing held on the above-referenced matter, you issued an
Order, dated August 24, 2001, changing the name of the minor child from Breanna
Denise Beaver to Hannah Denise Beaver. This Order was forwarded to the State
of Minnesota (where the child was born) in order to change the birth records to
reflect the new name. However, the Minnesota Department of Health rejected your
Order, stating that it did not conform to the language required by departmental
rule by directing that the Department change the birth record. (A copy of the letter
we received from Minnesota is enclosed for your ready reference.)
Therefore, in order to have the birth records amended, we request that you
issue a new order specifically directing the Minnesota Department of Health to
change the birth records. A proposed order is enclosed for your consideration. We
have also enclosed a self-addressed, stamped envelope for your convenience in
sending the new Order to us.
Thank you for your assistance in this matter.
Very truly yours,
C~.tfvL(~
Teresa R. McCormack
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