HomeMy WebLinkAbout10-1171Name: l?\ JDC-) c?\_)r-A a?
(Name of Person Who Wants to Change Their Name or Name of Parent of , rv
Minor Child Who Wants to Change Child's Name.
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Address: rj s
(Address of Person Who Wants to Change Their Name),; -- : `,
City: Fo 8\c, PA Zip: OaS
Phone: 6,?AS'71LiLA a _n
Email: f'__ V IUO PACZEaI.TOR.OQU c.:?
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IN RE: NAME CHANGE OF
(NAME OF PERSON WHO WANTS TO CHANGE THEIR
NAME OR IF MINOR CHILD, NAME OF PARENT ON
BEHALF OF NAME OF MINOR CHILD)
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 10 - 171 l;rvt 1 rrM
PETITION FOR CHANGE OF NAME
TO THE HONORABLE JUDGES OF SAID COURT:
The Petition of
(Name of Person Who Wants to Change Their Name Or Name of Parent of Minor Child)
represents:
Petitioner or Minor Child is \? C?dk nS who
(Name of Person Who Wants to Change Their Name)
resides at 1\ -C4,ec- cec? _ E(ln?.
(Complete Address of Person Who Wants to Change Their
0005
2. Petitioner or Minor Child's year of birth is: r:C>J
(Petitioner's or Minor Child's Year of Birth)
3. Petitioner or Minor Child has resided at the following addresses for the five (5)
years previous to the filing of this Petition:
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(Complete Addresses of all Places Person Who Wants to Change Their Name has Resided for the Past Five (5) Years)
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4. Petitioner or Minor Child desires and intends to change his/her name to:
(What is the Name that the Person Wants the Court to Change His/Her Name To)
5. If person who wants to change their name is under the age of eighteen (18)
years, please state the names and addresses of their mother and father:
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(If the Person Who Wants to Change Their Name is under Eighteen (18) Years of Age, List the Name and Address of the Child's
Mother and Father)
6. Petitioner or Minor Child provides the following reasons for this request:
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(State In Detail y You Want to Change Your Name)
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7. The proposed change in Petitioner or Minor Child's name, if granted, will not be
detrimental to the interests of any other person and is not against public interest.
8. The Petition is not filed to defraud creditors.
9. WHEREFORE, Petitioner or Petitioner on Behalf of Minor Child requests the
Court, pursuant to the Act of December 16, 1982, P.L. 1309, No. 295 § 2, 54 Pa.C.S. §
701, for the following:
a. to fix a hearing on this Petition;
b. to direct that notice be given on this Petition and hearing; and
c. to enter a decree changing the Petitioner or Minor Child's name from
Abe\\o. ?e??C-??s to??.be\\? ?v.??e..5o.yi n®
(Complete Present Name) (Complete Proposed New Name)
NAT QE PMTIONER
Print Name'of Petitioner
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VERIFICATION
I, t J lE
(Name of Person
I '-?V;./td
Wants To Change Their Name or Parent of Minor Child)
verify that the facts set
forth in the PETITION FOR CHANGE OF NAME are true and correct to the best of my
knowledge, information and belief. I understand that the statements herein are made
subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to
authorities.
I
Date
V
Signairefy??yoff Petitioner
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Print Name of Petitioner
IN RE: CHANGE OF NAME OF IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
(rnz,, I -Sa?,o o beli)4f Jsohell4.14115s
(NAME OF PERSON WHO WANTS TO CHANGE THEIR NO:
NAME OR IF MINOR CHILD, NAME OF PARENT ON
BEHALF OF NAME OF MINOR CHILD)
DECREE FOR CHANGE OF NAME
AND NOW, this day of 20 , following a hearing on
before this Court, and it having been determined
that the requirements of 54 Pa.C.S.A. § 701 have been satisfied, it is hereby ORDERED
and DECREED that the name of Petitioner or Minor Child,
is hereby changed to
and that Petitioner or Minor Child, from
this date forward, shall exclusively use and be known by the name of
BY THE COURT:
JUDGE
DISTRIBUTION:
"')aj i"C' -?II'5ha--
s Name and Address
IN RE: CHANGE OF NAME IN THE COURT OF COMMON PLEAS OF
CHERYL SAVINO CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION -LAW
NO. 10-1171 CIVIL TERM
ORDER OF COURT
AND NOW, this 23rd day of February, 2010, upon consideration of the attached
Petition for Change of Name, a hearing is scheduled for Friday, April 30, 2010, at 11:00
a.m., in Courtroom No. 1, Cumberland County Courthouse, Carlisle, Pennsylvania.
THE CAPTION in the above matter is hereby amended to reflect that the name
change is requested for the minor child, Isabella Jenkins.
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, Petitioner shall comply with all other requirements of C.C.R.P. 5,
and the Act of December 16, 1982, P.L. 1309, §6 (see 54 Pa. C.S. §701 [Historical and
Statutory Notes] [Main Volume]), and 54 Pa. C.S. §§701 et seq.
IN ADDITION, notice of the petition and time and place of the hearing shall
be provided to the child's natural father by Petitioner at least 10 days prior to the
hearing by regular mail and by certified mail to his last known address, and proof
of such service shall be filed of record prior to the hearing.
BY THE COURT,
~heryl Savino
711 Shaffer Street
Enola, PA 17025
Petitioner
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