HomeMy WebLinkAbout11-2851IN THE MATTER OF THE
CHANGE OF NAME OF
Alexis Marie Holden
BY
Tara Adelle Rock
46 Short Lane
Shippensburg,PA 17257
FOR CHANGE OF NAME TO
Alexis Marie Rock
IN THE COURT OF COMMON
PLEAS
;v co
COMMONWEALTH OF
PENNSYLVANIA
FOR Cumberland
COUNTY
FAMILY DIVISION
:Ja L '
Action/Cause No. I- 6- Oro
PETITION TO CHANGE NAME OF A MINOR
COMES NOW, Tara Adelle Rock , on behalf of
Alexis Marie Holden , by this Petition and upon being duly sworn, respectfully
represents unto this Honorable Court as follows:
1. That the Petitioner, Tara Adelle Rock , is the mother of the minor.
2 Alexis Marie Holden was born on March 14, 2010 in
Chambersburg Pennsylvania
3. The minor child presently resides at 46 Short Lane, Shippensburg, PA 17257
with Tara Adelle Rock . The minor child has lived with
Tara Adelle Rock in Cumberland
year(s) immediately prior to filing this
County, Commonwealth of Pennsylvania for approx.1
Petition. The minor child has also lived in the following places for the past five years
preceding the filing of said Petition:
Dates (to/from) Address
Present / 03/2010 46 Short Lane, Shippensburg, PA 17257
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4. The mother of the minor is Tara Adelle Rock
46 Short Lane, Shippensburg, PA 17257
5. The father of the child is Thomas Herbert Edward Holden
320 East Queen Street, Chambersburg, PA 17201
6. The guardian(s) of the child is/are N/A
was/were appointed
guardian(s) on Corresponding documentation is
attached hereto for the Court's review.
7. The minor child's present name is Alexis Marie Holden . This is the current name of
the minor child on his/her social security card and all other records.
8. That Alexis Marie Holden wishes to change his/her name to
Alexis Marie Rock
9. That the Petitioner prays for the change of name for the following reason(s) (describe in
detail): It is in Alexis's best interest to have my last name. I have her father's consent in writing that it is best
to have her last name be Rock
10. That the proposed change of name, if granted, will not be detrimental to the interests of any
other person and is not against the public interest.
11. The petition is not being filed to defraud creditors. The minor child has never been
convicted of a felony.
12. That the minor child has not been known by another name.
13. It is in the best interests of the minor child to change his/her name.
WHEREFORE, the Petitioner prays that by an Order of this Honorable Court, made and
entered herein, the minor child's name be changed from, Alexis Marie Holden to and
decreed to be Alexis Marie Rock
Respectfully Submitted,
Signature
Address: 46 Short Lane
who resides at
who resides at
IN THE MATTER OF THE
CHANGE OF NAME OF
Alexis Marie Holden
BY
Tara Adelle Rock
46 Short Lane
Shippensburg, PA 17257
FOR CHANGE OF NAME TO
Alexis Marie Rock
IN THE COURT OF COMMON
PLEAS
COMMONWEALTH OF
PENNSYLVANIA
FOR Cumberland
COUNTY
FAMILY DIVISION
Action/Cause No.
CONSENT TO NAME CHANGE
Comes now,
Thomas Herbert Edward Holden and states that I am the non-
petitioning parent/guardian of Alexis Marie Holden
his/her name be changed from Alexis Marie Holden
Alexis Marie Rock
Co senting Parent's/Signature
Address: 320 East Queen Street
City, State Zip: Chambersburg, PA 17201
Phone: (717) 300-8120
COMMONWEALTH OF PENNSYLVANIA
TO WIT;
I HEREBY CERTIFY, that on this day of &A-- '20 /1 ,
before me, the subscriber, a Notary Public of the Commonwealth of Pennsylvania, in and for
aJ m rg(a r)d t)i ,., aforesaid, personally appeared
ThimQP 4.rbrr-? W?Wn, And made oath in due form of law that the matters and facts set
forth in the foregoing document are true to the best of his/her knowledge, information, and
belief.
and I hereby consent that
to
AS WITNESS my hand and Notarial Seal.
City, State Zip: Shippensburg, PA 17257
Phone: (717) 262-8970
VERIFICATION
COMMONWEALTH OF PENNSYLVANIA
TO WIT;
I HEREBY CERTIFY, that on this ?- day of AjajT V) , 201 I
before me, the subscriber, a Notary Public of the Commonwealth of Pennsylvania, in and for
LI-n o? dra. n aforesaid, personally appeared
Uornn .) j-(ej-bt r+ I n and made oath in due form of law that the matters and
facts set forth in the foregoing Petition are true to the be of his/her knowledge, information, and
belief.
AS WITNESS my hand and Notarial Seal.
otary Public
My Commission Expires: ftn2
h
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
PAMELA A. SWITALSKI, Notary Public
eoro of Shippensbur0, Cumberland County
My Commission Expires March 24, 2014
21
IN THE MATTER OF THE
CHANGE OF NAME OF
Alexis Marie Holden
BY
Tara Adelle Rock
46 Short Lane
Shippensburg, PA 17257
FOR CHANGE OF NAME TO
Alexis Marie Rock
IN THE COURT OF COMMON
PLEAS
COMMONWEALTH OF
PENNSYLVANIA
FOR Cumberland
COUNTY
FAMILY DIVISION
Action/Cause No.11- WS51 Civil
G
A
PLEASE TAKE NOTICE that a Petition to Change Name of a Minor in the above case
wherein Petitioner, Tara Adelle Rock on behalf of Alexis Marie Holden
is seeking ayname change to Alexis Marie Rock will come on for hearing on
the a S day of , 2011 , atQfto'clock a.m./pim in this Court.
Any person desiring to object to he Petition may appear at the hearing or file a written response
or objection with the Clerk of Court of Common Pleas of Cumberland County,
Pennsylvania whose address is 1 Courthouse Square, Carlisle, PA 17013
Any response or objection must e filed on or before on the Ile"' day of
20 I t
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Judge
Submitted By:
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Petitioner's Signature
Petitioner: Tara Adelle Rock
Address: 46 Short Lane
City, State Zip: Shippensburg, PA 1 257
Phone: (717) 262-8970
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IN THE MATTER OF THE
CHANGE OF NAME OF
Alexis Marie Holden
BY
Tara Adelle Rock
46 Short Lane
Shippensburg, PA 17257
FOR CHANGE OF NAME TO
Alexis Marie Rock
FAMILY DIVISION
Action/Cause No. - <Z 6'l Civil 7iG'M
ORDER FOR HEARING
NOW on this the day of , 20_x, the Court finds
that the Petition to Change Name of a Minor in the above case wherein Petitioner,
Tara Adelle Rock
IN THE COURT OF COMMON
PLEAS
COMMONWEALTH OF
PENNSYLVANIA
FOR Cumberland
COUNTY
on behalf of Alexis Marie Holden
is seeking a
name change to Alexis Marie Rock' should be heard on the ,?-SNay of
20at 1,?0$'clock a.m.f= in this Court.
Judge
Submitted By:
4iFZ
Petitioner's Signature
Petitioner: Tara Adelle Rock
Address: 46 Short Lane
City, State Zip: Shippensburg, PA 11257
Phone: (717) 262-8970
/7 orno?S NWdeh
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IN RE: PETITION FOR IN THE COURT OF COMMON PLEAS OF
CHANGE OF NAME CUMBERLAND COUNTY, PENNSYLVANI A
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ALEXIS MARIE HOLDEN NO. 11-2851 CIVIL
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IN RE: PETITION FOR CHANGE OF NAME =
ORDER OF COURT
AND NOW, this 111h day of August, 2011, after hearing of the within Pe-ft ion' an(ii)n
presentation of proof of publication of notice as required by law, and it appearing that there is
no legal or other objection to the granting of the prayer of the petition,
IT IS ORDERED AND DECREED that the name of Alexis Marie Holden is hereby
changed to Alexis Marie Rock.
By the Court,
M. L. Ebert, Jr., J.
Tara Rock - 6zd Cei'iveted
Petitioner 8/11 f'1i
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