HomeMy WebLinkAbout03-40041N THE MATTER OF :
PETITION FOR CHANGE OF NAME OF :
MELISSA ANN TEETS :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
PETITION FOR CHANGE OF NAME
The Petitioner~ Melissa Ann Teets, through her counsel, Brian C. Bornman, Esquire,
requests that this Court enter a change of name for her pursuant to 54 Pa.C.S.A. §701 et seq., and
in support thereof represents as follows:
l. Petitioner, Melissa Ann Teets, is a resident of Cumberland County, Pennsylvania,
and has resided at the following locations during the five (5) years preceding the filing of this
Petition:
3.
4.
5.
Ann Am~o.
A. 320 Rear Bridge Street, Apt. 96, New Cumberland, PA - August 1, 2003 to
present;
B. 609 Bosler Avenue, Lemoyne, PA 17043 March 2002 - August 2003;
C. 514 S. Third Street, Lemoyne, PA 17043 - April 2001 to March 2002;
D. 804 N. Second Street, Harrisburg, PA 17104 - February 1999 to April 2001.
Petitioner desires that her name conform with the name of her natural mother.
Petitioner's name currently is that of her ex-husband.
Petitioner does not desire to resume her maiden name.
Petitioner requests that her name be changed from Melissa Ann Teets to Melissa
Petitioner.
7.
There are no judgments or decrees of like character of record against the
Petitioner has not been convicted of a crime nor has Petitioner ever been the
subject of a child abuse investigation.
8. Petitioner does not desire to have her name changed for any dishonest or
fraudulent purpose.
WHEREFORE, Petitioner requests that this Court enter a decree changing her name from
Melissa Ann Teets to Melissa Ann Amato.
Respectfully submitted,
Date:
Kline Law Office
714 Bridge Street
Post Office Box 461
New Cumberland, PA 17070-046l
(717) 770-2540
VERIFICATION
1 verify that the statements made in the foregoing Petition For Change of Name are true and
correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.
Section 4904 relating to unswom falsification to authorities.
Date
MELISSA ANN TEETS
~ THI~ I(IDS OFP~
VERIPI I i 7'/3/ '(
oCiXt ......
S SECURITY #:. 20
: m~ :' "' a anc~
The above na p~rson has 'for a ;"
pursuant' .to Chapter' 63 O~ :.23"Pa. c0nS°ti~da~'. "W' the ..Child
l~,,ote, ct[ye 'Services. Law..NO.RECORD EXISTS in the
,!,,.l~b. ii.~ .W¢Ifare's.~:~a~?i..'~qT;Ceniral 'R'egis~ry listing'the applicant as
',,:-.lhd~catec~ ,qr, Founded ,report of child abq~,,~,?or~..an ,,
., ,.~dmm~strat~rs ar6 .re~mred, to keep a copy of th~s ,child abus~
.'-" clearance, on::ffle.. Any ;aerson,alt~rm$ the content.s:?of-tfi~s~ d ,.oe~Lr~l I {.Z:,'~:.H, ~ ,'~:' ,. i
. ,, ....., .,~,-;~,
CHiLDLINE AND
ChildLine
P.O.
IN THE MATTER OF
PETITION FOR CHANGE OF NAME OF
MELISSA ANN TEETS
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO.3
ORDER
ANDNOW, this 2-~Fi'ca day of //jfAj4x~_at''~' ,2003, onthe
Motion of Petitioner, it is ORDERED that a hearing on the Petition for the Change of Name is
fixedfor ~.~, ~h~/~c~{~ ,2003, at /JOri ?~.M.o'clock, in
Room.,~ of the Cffumberland County Courthouse, Carlisle, Pennsylvania.
The Petitioner is directed to give notice of the filing of the Petition and of the date of the
hearing by publication in two newspapers of general circulation in this county, one of which may
be the official paper for the publication of legal notices in this county. Petitioner is further
directed to give notice of the filing of the Petition and of the date of the heating to any non-
petitioning parent of a child whose name will be affected by certified mail.
BY THE COURT:
IN THE MATTER OF :
:
PETITION FOR CHANGE OF NAME OF :
:
MELISSA ANN TEETS :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANI
NO.
ORDER
Now, this O 2oo u on
AND day of
consideration of the attached Petition of Melissa Ann Teets for change of name and upon
presentation of proof of publication of notice as required by law, together with proof that there
are no judgments or decrees of record or any other matter of like character against Petitioner, and
it appearing that there is no lawful objection to the request of the Petitioner, it is hereby
ORDERED that the name of Petitioner, MELISSA ANN TEETS, is changed to MELISSA ANN
AMATO.
BY THE COURT: