HomeMy WebLinkAbout11-6704IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW , I
IN RE: CHANGE OF NAME OF MINOR, DOCKET NO: it - Co?D ?ivcl -rat*
JOSHUA TYLER WHITE TO
JOSHUA TYLER KENDALL C
PETITION FOR CHANGE OF NAME OF MINOR zrn rn,-
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TO THE HONORABLE JUDGE OF SAID COURT: v?-z r o40
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Petitioner makes the following declaration: 54= CO C
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1. The minor was born on October 20, 2006, in Camp Hill, CumbeKanFCoaty,
Pennsylvania. A certified copy of the minor's birth certificate is attached to this Petition as Exhibit
"A„
2. The minor was named Joshua Tyler White at birth, and as of the date of this Petition,
the minor has always been known by that name.
3. The minor resides at 45 Liberty Drive, Mt. Holly Springs, Pennsylvania and has lived at
this address since January of 2007. The Petitioner resides at 45 Liberty Drive, Mt. Holly Springs,
Pennsylvania.
4. The father of the minor is Derek A. White. Derek White resides at 9 South Baltimore
Avenue, Apartment 9, Dillsburg, Pennsylvania. The mother of the minor is Amanda K. Kendall.
Amanda Kendall resides at 45 Liberty Drive, Mt. Holly Springs, Pennsylvania.
5. Petitioner seeks to change said minor's name to Joshua Tyler Kendall and offers the
following reasons for seeking to do so:
a. Mother, Amanda Kendall, has sole legal and physical custody of minor:;
b. Father, Derek White, has agreed to the name change and has agreed to have no
contact with minor, so long as Mother, Amanda Kendall, agrees to not pursue
any financial support for minor as stated in the agreement attached her as
Exhibit "B".
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6. By Order dated February 2, 2010, Petitioner was granted sole and exclusive legal
custody of minor and sole and exclusive physical custody of minor. This Order additionally states that
Derek A. White agrees to voluntarily terminate his parental rights in the event of any future adoption
proceeding. The Order dated February 2, 2010 is attached hereto as Exhibit "C".
7. The minor does not have any outstanding judgments, has never been convicted of a
crime, and is not involved in any pending legal actions.
8. At the time Mother, Amanda Kendall, completed the application for birth record, she
was in a domestic violence situation and was coerced by Father, Derek White, to give child Father's
last name.
9. Attached to this Petition as Exhibit "D" is a copy of minor's fingerprints in accordance
with 54 P.S. §702(b)(4).
WHEREFORE, Petitioner, Amanda Kendall prays this Honorable Court order the minor's
name changed as follows:
From: Joshua Tyler White
To: Joshua Tyler Kendall
Amanda K. Kend 11, Petitioner
VERIFICATION
I, Amanda K. Kendall, affirm under penalty of perjury that I am the Petitioner in the foregoing
Petition to Change Name of Minor and that all statements in this Petition are accurate to the best of my
knowledge.
Date: 1 1( i " (ggq ' rdau
Amanda K. Kendal , Petitioner
45 Liberty Drive
Mt. Holly Springs, Pennsylvania 1.7065
Subscribed and sworn to me on this daYofd '2011.
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Notary
My Commission expires U"?d --tz, a0 ( 3
CoNIM01OWN OF PENNSYLVANIA
NOTARIAL SEAL
LISA ANN HIGHLANDS
SILVER SPRING TWP., CUMBERLAND COUNTY .
MY COMMISSION EXPIRES AUGUST 20, 2013 '
Eel
DATE - _`------- ------ OF BIRTH October 20, 2006
COUNTY
OF BIRTH CUMBERLAND
FILE
NO 132148-2106
DATE
FILED December 4, 2006
This IS to Certify that INS to a true Copy Of the record which Is on file in the Pennsylvania Department of Health.
in accordance with Act 66. P.L 304, approved by the General Assembly, June 29, 1953.
H105.105.
i
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
Frank Yerapolf
State Registrar
WARNING: THIS DOCUMENT IS PRINTED ON SECURITY WATERMARKED PAPER
11 NOT ACCEPT WITHOUT VERIFYING THE PRESENCE OF THE WATERMARK.
9364233
EXHIBIT B
I Amanda K. Kendall on June 25th 2009 will have April and May's child support processed
through Domestic Relations. I will also receive a check on July 1&, 2009 in the amount of $166.00 for
half of June's child support as agreed upon. This is the only and last personal payment to be made to
Amanda K. Kendall for child support as agreed. Also as of the above date of June 25, 2009, 1 am
terminating child support in the case of Joshua Tyler White and will NEVER reinstate child support again
for any reason as agreed upon. I have no authority to terminate the $3,800.00 owed to the Department of
Welfare.
I Derek A. White on June 25th 2009, agree if and when the time comes for adoption, I will
terminate my parental rights of Joshua Tyler White as agreed upon. It is also agreed that Joshua Tyler
White's name can be changed to Joshua Tyler Kendall. Also as of the date above of June 25, 2009, 1 will
have the custody complaint withdrawn and will NEVER reinstate for any reason for Joshua Tyler White as
agreed upon. I will also be paying the owed Comcast bill of 141.00 on July 10"', 2009.
Signed:
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Ahghda K. Kendall
Derek A. White
EXHIBIT C
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)EREK WHITE, : IN THE COURT OF COMMON PLEAS OF
Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
v : NO. 2009-6850
AMANDA KENDALL, : IN CUSTODY
Defendant
ORDER
AND NOW, this day of 2010, upon consideration of the
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parties' Stipulation For Entry of Custody Order and Defendant's Motion with respect thereto, it is
hereby ORDERED as follows:
1. Amanda Kendall shall have sole and exclusive legal custody of the parties' son, Joshua
Tyler White, born October 20, 2006.
2. Amanda Kendall shall have sole and exclusive physical custody of the parties' son,
Joshua Tyler White.
3. Derek White agrees that in the event of any future adoption proceeding initiated with
respect to the adoption of Joshua Tyler White that Plaintiff Derek White shall agree to the
voluntarily termination of his parental rights with respect to Joshua Tyler White.
BY THE COURT:
J.
LAW OFFICES
SNELBAKER &
BRENNEMAN, P.C.
TRUE COPY-FROM RECORD
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and I* atld Carlisle,
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EXHIBIT D
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IN RE: CHANGE OF NAME OF IN THE COURT OF COMMON PLEAS OF
MINOR, JOSHUA CUMBERLAND COUNTY, PENNSYLVANIA
TYLER WHITE TO
JOSHUA TYLER CIVIL ACTION - LAW
KENDALL NO. 2011-6704 CIVIL
IN RE: PETITION FOR CHANGE OF NAME OF MINOR
ORDER
AND NOW, this day of September, 2011, a brief hearing in this matter is set
for Friday, October 21, 2011, at 11:30 a.m. in Courtroom Number 4, Cumberland County
Courthouse, Carlisle, PA. A copy of the Petition and this Order to be sent by the petitioner to
Derek A. White by regular and certified mail.
BY THE COURT,
Kevin A . ess. P. J.
Amanda Kendall
Petitioner z rn n -
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IN RE: CHANGE OF NAME :
OF MINOR, JOSHUA TYLER :
WHITE TO JOSHUA TYLER
KENDALL
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 2011-6704 CIVIL TERM
IN RE: PETITION FOR CHANGE OF NAME
ORDER OF COURT
AND NOW, this 21st day of October, 2011, this matter
having been called for hearing, the within petition for
change of name of minor is granted, and the minor Joshua
Tyler White shall hereafter be known as Joshua Tyler
Kendall.
By the Court,
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Kevi A Hess, P.J.
Ms. Amanda Kendall
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45 Liberty Drive
Mt. Holly Springs, PA r
Petitioner ?.=y
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