HomeMy WebLinkAbout10-4168?,Ql Q J'?i 22 ? ?? ? : 4 6
IN THE COURT OF COMMON PLE ,F-.,, ".r1 -r;?t?l?CtY
CUMBERLAND COUNTY, PENNSYLVAi yI-?r? `A
In Re:
Dakota Shopp, NO. `4 Civil Term
Born: 11/2/99
Civil Action - Law
PETITION FOR NAME CHANGE.
AND NOW, comes Russell Clavey, Father of Dakota Shopp, joined by Petitioner,
Dakota Shopp, by and through their attorney, Jane Adams, Esquire, and respectfully
requests this Honorable Court to change Dakota Shopp's name, for the following
reasons,
1. Russell Clavey, (hereinafter referred to as "Father") currently lives at 2 W.
Main St., Apt. 2, Newville, Cumberland County, Pennsylvania, 17241.
2. Petitioner, Dakota Shopp, (hereinafter "Petitioner") lives with his Father at 2
W. Main St., Apt. 2, Newville, Cumberland County, Pennsylvania, 17241.
3. Petitioner Dakota Shopp was born on November 2, 1999, He is eleven (11)
years old.
4. Petitioner has lived with his Father primarily, pursuant to an Order of Court
entered under a dependency action, since 2003. Dependency was terminated in 2003.
5. Petitioner's Mother is Maryann Dyarman. She lives at 201 Campground
Road, Carlisle, Pa. 17013.
6. Petitioner currently has Mother's maiden surname, and does not share a
common last name with his Mother or Father.
7. Petitioner wishes to change his name to Dakota Clavey.
8. Petitioner wants to use the last name of his Father since it would be less
cumbersome and he feels more comfortable having the same last name as his natural
parent.
Al? A/00-
9. Petitioner believes that using his natural Father's last name would avoid
confusion regarding school and medical records.
10. Petitioner's Father joins in this petition and has reviewed the information in
this petition; his verification is attached.
11. Natural Mother will be notified of this petition and the hearing pursuant to the
statute.
12. Petitioner is under eighteen (18) years old and has no outstanding credit debt
that could be avoided through a name change.
13. Petitioner has no outstanding federal or state tax debt that could be avoided
through a name change.
WHEREFORE, Petitioner requests that this Honorable Court Order change his
name.
Respectfully submitted,
Date: l? (dl?)
One Adams, Esquire
I.D. 0.79465
17 . South St.
arlisle, Pa. 17013
(717) 245-8508
ATTORNEY FOR PETITIONER
VERIFICATION
I verify that the statements made in this petition are true and correct. I
understand that false statements herein are made subject to the penalties of 18
Pa.C.S. §4904, relating to unsworn falsification to authorities.
Dj,k,-- ,a
Date: Dakota Shopp, Petitioner
I am the natural Father of Petitioner and I join in this petition and verify that the
statements made in this petition are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to
unsworn falsification to authorities.
Date: C i t: -i0 Russell Clavey, Natural Father
3
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
In Re:
Dakota Shopp, NO. Jf~" ~~~~ Civil Term
Born: 1112199 ~ Ql'~ - yL~'(~y
Civil Action -Law
ORDER
AND NOW, this day of , 2010, upon
consideration of the within Petition for Name Change, a hearing is scheduled for the
~b~day of OZ ~~ in Courtroom No. ~ at ~ ~~ 30
o'clock ~.m. , on the fourth floor of the Cumberland County Courthouse, Carlisle,
Pennsylvania.
Petitioner is directed to give notice of the hearing by publication, pursuant to the
Act of December 16, 1982, P.L. 1309, No. 295, §2, 54 Pa. Cons. Stat. Ann. §702
~ ~ ,:~
Prothonotary no more than two days prior to hearing. :~-
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BY COURT• ~ ~
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(Names). Petitioner will obtain certifications of actions filed of record from the
J.
cc: Jane Adams, Esquire, for Petitioner
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cuma?L '0
IN THE COURT OF COMMON PLEAS OF PEWSYLV"I
CUMBERLAND COUNTY, PENNSYLVANIA
In Re:
Dakota Shopp, NO. 10 - 4168 Civil Term
Born: 11/2/99
Civil Action - Law
ORDER
2?,?h
AND NOW, this ? day of August, 2010, after hearing, and upon
consideration of the Petition to Change Name and the exhibits filed, it is hereby ordered
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and directed that Dakota Shopp shall hereafter be known as: Dakota Clavey.
By the Court:
J.
CC' Jane Adams, Esquire
Nand 3o/Jd
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