HomeMy WebLinkAbout10-4231r
By: Andrew H. Shaw, Esquire T THE
I.D. No: 87371
200 S. Spring Garden Street 2? 10 guff ??r i `7• i'
Carlisle, PA 17013
(717) 243-7135 Attorney for Petitioner
t"L_ 4 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN THE MATTER OF PETITION FOR
CHANGE OF NAME OF No.
FALLYN NICOLE LENTZ
Name Change
PETITION FOR CHANGE OF NAME
AND NOW, comes Fallyn Nicole Lentz in and through her mother Jennifer Renee
Miller, by and through their attorney, Andrew H. Shaw, and files this Petition for Change of
Name and in support thereof avers as follows:
1. Fallyn Nicole Lentz, (hereinafter "Petitioner") was born on August 29, 2004, and is
currently Five (5) years old.
2. Petitioner resides at 120 East Locust Street, Mechanicsburg, Cumberland County,
Pennsylvania with her birth mother, Jennifer Renee Miller, her mother's fiance, Joshua
Lee Shelly and Joshua Lee Shelly's three biological children.
3. Petitioner's biological father is Jackie Rouscher Lentz, who currently resides at 401
Ridge Avenue, Apt. 211, York, York County, Pennsylvania.
4. Petitioner seeks to have her name changed from Fallyn Nicole Lentz to Fallyn Nicole
Shelly.
5. Petitioner's mother, Jennifer Renee Miller is engaged to marry Joshua Lee Shelly on July
10, 2010.
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6. Upon her marriage, Jennifer Renee Miller will assume a married name of Jennifer Renee
Shelly.
7. Petitioner seeks a change of name because she desires to share the same last name as her
birth mother, birth mother's husband and her birth mother's husband's three children.
8. Petitioner currently has the last name of her biological father.
9. Petitioner's biological father, Jackie Rouscher Lentz, maintains minimal to no contact
with Petitioner, does not provide any financial support to Petitioner, and is minimally
involved in Petitioner's life.
10. Petitioner's residence for the past 5 years has been as follows:
a. 120 East Locust Street, Mechanicsburg, Cumberland County, Pennsylvania (January
2009 to present);
b. 1 South Chestnut Street, 2°a Floor, Dillsburg, York County, Pennsylvania (May 2008 to
January 2009);
c. 1020 Alpine Road, Wellsville, York County, Pennsylvania (July 2007 to May 2008);
d. 4 Stoney Rune Road, Unit 1, Dillsburg, York County, Pennsylvania (December 2006 to
July 2007);
e. 7 Mallard Court, Mechanicsburg, Cumberland County, Pennsylvania (March 2006 to
December 2006);
f. 150 Honey Road, Dillsburg, York County, Pennsylvania (September 2005 to March
2006);
g. 3203 Village Court Drive, Dover, York County, Pennsylvania (November 2004 to
September 2005);
2
h. 150 Honey Road, Dillsburg, York County, Pennsylvania (August 2004 to November
2004).
WHEREFORE, Petitioner respectfully requests this Honorable Court to grant her request
to change her name from Fallyn Nicole Lentz to Fallyn Nicole Shelly.
Date: --?- U
Respectfully Sub i e ,
By:
drew haw, Esquire
I.D. No. 87371
200 S. Spring Garden Street
Carlisle, PA 17013
(717) 243-7135
Attorney for Petitioner
3
VERIFICATION
I, Jennifer Renee Miller, do verify that I am familiar with the facts contained in the above
Petition for Name Change and that the said facts and statements made therein are true and correct
to the best of my knowledge, information and belief. I understand that false statements herein
are subject to the penalties of 18 Pa. C.S. § 4904 relating to unworn falsification to authorities.
Dated:
ffer'
enee Miller
JUN 2g2U1U
No.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION -LAW
IN THE MATTER OF PETITION FOR
CHANGE OF NAME OF
FALLYN NICOLE LENTZ
Name Change
ORDER
Cum./
AND NOW, this ~ day of , 2010, a hearing on the Petition for
Change of Name is scheduled for the ~ ~ day of , 2010, at ~ ~ ~.~
am/pfii, in Courtroom No. 5 on the 4th floor of the Cumberland County Courthouse, 1
Courthouse Square, Carlisle, Pennsylvania.
Petitioner is directed to give notice of the hearing by publication in the Cumberland Law
Journal and one newspaper of general circulation in Cumberland County, once a week for two
consecutive weeks. ~~,~ Hw `' ~G~/~~v-t no {i'c e o~ ~ ~~~~~ «~~k/'e
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Petitioner will obtain certifications of actions filed of record from Clerk of Courts and
instruments of indebtedness from Prothonotary and Recorder of Deeds dated no more than two
days prior to the hearing.
BY THE COURT:
ATTEST: n
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Copies to: Andrew H. Shaw, Esquire ~~ ~ -.
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION -LAW
IN THE MATTER OF PETITION FOR
CHANGE OF NAME OF No. 10-4231 CIVIL
FALLYN NICOLE LENTZ .
Name Change
ORDER
f~'
AND NOW, this l~ day of August, 2010, upon hearing on the attached Petition of
Fallyn Nicole Lentz 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 Fallyn Nicole Lentz, and it appearing that there is no lawful
objection to the request of Fallyn Nicole Lentz,
IT IS HEREBY ORDERED AND DECREED that the name of Fallyn Nicole Lentz be
and is hereby changed as follows:
Fallyn Nicole Shelly.
BY THE COURT:
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