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IN RE: : IN THE COURT OF COMMON PLEAS
PETITION FOR NAME CHANGE : CUMBERLAND COUNTY, PENNSYLVANIA
OF MICHAEL A. KINER,
A MINOR CHILD : DOCKET NO. 1,.,- 106 L - l
CIVIL ACTION - LAW
PETITION FOR CHANGE OF NAME
AND NOW, comes the Petitioner, Kathryn M. Hein, mother of Michael A. Kiner,
a minor child, by and through her attorney, Mindy S. Goodman, Esquire, and respectfully
represents and avers as follows:
1. Petitioner, Kathryn M. Hein, resides at 326 Whiskey Spring Road,
Dillsburg, Cumberland County, Pennsylvania, having so resided since
approximately 2004.
2. The natural father of Michael A. Kiner is Steven A. Kiner, whose last
known address was 15 West Main Street, P.O. Box 607, New Kingston,
Cumberland County, Pennsylvania.
3. Petitioner has sole legal and sole physical custody, of the minor child,
Michael A. Kiner, by Order of Court dated June 15, 2011. (A copy of the
Order of Court is attached hereto as Exhibit A.)
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4. As part of the Stipulation for an Agreed Order of Custody that became an
Order of Court on June 15, 2011, the natural father indicated he would not
object to the name change for the minor child. (See Paragraph 2, Page 2
of the Order of Court dated June 15, 2011.)
5. The minor child's date of birth is September 8, 2004 and, therefore, the
minor child is seven (7) years of age. The minor child's full name is
Michael Anthony Kiner. (The child's original birth certificate shall be
presented at the hearing.)
6. During the past five years Petitioner has resided in Cumberland County, a
portion of which was at the address identified in Paragraph 1 above.
7. Because of natural father's lack of involvement with the minor child,
Petitioner avers that it is in the child's best interest to have his name
changed so that the last name of the minor child and his mother are the
same.
8. If the minor child retains the surname of his biological father who has no
involvement with the minor child, the minor child may have to address
questions about his name and where the "Kiner" name came from, which
places an unnecessary burden on the minor child.
9. The minor child knows that his mother's surname is "Hein," the family
that he has a connection to is named "Hein," the minor child has been
using the surname "Hein" consistently at school and would like to
formally change his name so that he shares a surname with the relatives
with whom he has a close relationship.
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10. After much contemplation, it is the desire of the Petitioner, the Petitioner's
extended family, and the minor child to formally and legally change the
name of the minor child.
11. Therefore, Petitioner desires to change the minor child's name to from
Michael Anthony Kiner to Michael Anthony Hein.
WHEREFORE, Petitioner respectfully requests that this Honorable Court grant
Petitioner's request to change the name of the minor child from Michael Anthony Kiner
to Michael Anthony Hein.
Respectfully submitted,
Z /6'/ 2 By_
Date Mindy S. Goodman, Esquire
Pa. Supr. Ct. I.D. No. 78407
2215 Forest Hills Drive, Suite 35
Harrisburg, PA 17112
(717) 540-8742
Attorney for Petitioner
VERIFICATION
I hereby verify that I have read the foregoing PETITION FOR CHANGE OF
NAME and believe it to be true and correct to the best of my knowledge, information,
and belief. I understand that if false statements are made herein I am subject to the
penalties of 18 Pa.C.S. Section 4904 relating to unworn falsification to authorities.
DATE: 2-116-11 2 O=L& /W /-i?/ -,
Ka M. Hein, Petitioner
KATHRYN M. HEIN,
Plaintiff
vs.
STEVEN A. KINER,
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,, PENNSYLVANIA
NO. IPMS3 L'M'/
CIVIL ACTION - LAW
IN CUSTODY
ORDER OF COURT
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AND NOW, this day of 2011, it is hereby
ORDERED AND DECREED that the attached Stipulation for an Agreed Order of
Custody is made an Order of Court and said Stipulation is adopted in its entirety
and incorporated herein as an Order of Court.
BY THE COURT:
Dated:
Judge
Distribution:
1. Mindy S. Goodman, Attorney at Law, Attorney for Plaintiff, 2215 Forest Hills Drive,
Suite 35, Harrisburg, PA 17112; Telephone - 717-540-8742; Fax - 717-540-8743;
Email goodmanlawnverizon.net
2. Steven A. Kiner, 15 West Main Street, P.O. Box 607, New Kingston, PA 17072
TRUE COPY FROM RECORD
M Testirtway whereof, I here unto set my hand
and the seal of saW at Carlisle, Pa. CT
This !(o d .20 t I
5 , prothonotary
A
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KATHRYN M. HEIN,
Plaintiff
vs.
STEVEN A. KINER,
Defendant
STIPULATION FOR AN AGREED ORDER OF CUSTODY
AGREEMENT, made this , day of 2011,
by and between KATHRYN M. HEIN, hereinafter referred to as "Mother," and
STEVEN A. KINER, hereinafter referred to as "Father."
WITNESSETH
WHEREAS, Plaintiff and Defendant are the natural parents of one minor
child whose name and date of birth are as follows:
MICHAEL A. KINER Date of Birth September 8, 2004
WHEREAS, the parties have come to an agreement concerning the
issues of child custody; and
WHEREAS, the parties desire that this Stipulation be entered as an Order
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYtVA N
IA
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by the Court of Common Pleas of Cumberland County, Pennsylvania;
NOW THEREFORE, intending to be legally bound, the parties hereby
stipulate and agree as follows:
LEGAL CUSTODY
1. Mother shall have SOLE LEGAL CUSTODY of the parties' minor
child, legal custody being defined as the legal right to make major decisions
affecting the upbringing of the child, including but not limited to medical, religious,
and educational decisions.
2. In order for school and life in general for the minor child to be
easier, Mother shall have the right to file a petition with the court seeking to
change the minor child's name from Michael A. Kiner to Michael A. Hein and
Father shall not object to a name change in the minor child's name.
PHYSICAL CUSTODY
1. Mother shall have SOLE PHYSICAL CUSTODY of the minor child,
physical custody being defined as actual physical possession and control of the
child. At the present time, Father does not intend to be involved in the life of the
minor child.
2. It is understood and stipulated by the parties that upon mutual
agreement, a schedule may be agreed upon between the parties if Mother
determines such a schedule would be in the best interest of the child.
3_ Neither party may relocate from the jurisdiction of central
Pennsylvania unless:
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(a) Every individual who has custody rights to the child consents to
the proposed relocation; or
(b) The court approves the proposed relocation.
(c) The party proposing the relocation shall notify every other
individual who has custody rights to the child by sending a notice by
certified mail, return receipt requested;
(d) The notice shall be given no later than:
(i) the 60th day before the date of the proposed relocation; or
(ii) the tenth day after the date that the individual knows of the
relocation, if:
(A) the individual did not know and could not reasonably
have known of the relocation in sufficient time to comply with the
60-day notice; and
(B) it is not reasonably possible to delay the date of
relocation so as to comply with the 60-day notice.
(e) Except as provided by section 5336 of the Domestic Relations Act
(relating to access to records and information), the following information, if
available, must be
included with the notice of the proposed relocation:
(i) The address of the intended new residence.
(ii) The mailing address, if not the same as the address of the
intended new residence.
(iii) Names and ages of the individuals in the new residence,
including individuals who intend to live in the new residence.
(iv) The home telephone number of the intended new residence, if
available.
(v) The name of the new school district and school.
(vi) The date of the proposed relocation.
(vii) The reasons for the proposed relocation.
(viii) A proposal for a revised custody schedule.
(ix) Any other information which the party proposing the relocation
deems appropriate.
(x) A counter-affidavit as provided under subsection (d)(1) of
section 5337 of the Domestic Relations Act which can be used to
object to the proposed relocation and the modification of a custody
order.
(xi) A warning to the nonrelocating party that if the nonrelocating
party does not file with the court an objection to the proposed
relocation within 30 days after receipt of the notice, that party shall
be foreclosed from objecting to the relocation.
(f) If any of the information set forth in paragraph (e) is not known when
the notice is sent but is later made known to the party proposing the
relocation, then that party shall promptly inform every individual who
received notice under this subsection.
WHEREFORE, the parties request that this Stipulation be entered
as an Order of the Court.
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Witness Kat ryn M. Hein, Plaintiff
Witness 'Ifeven A.'Kiner, Defendant
IN RE: : IN THE COURT OF COMMON PLEAS
PETITION FOR NAME CHANGE : CUMBERLAND COUNTY, PENNSYLVANIA
OF MICHAEL A. KINER,
A MINOR CHILD : DOCKET NO. 1616 (N
CIVIL ACTION - LAW
ORDER
AND NOW, this3 day of y? , 2012, upon
consideration of the Petition to Change Name filed in the above-captioned matter, a
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hearing on the Petition is hereby scheduled for 2012, at
?: ys a.m., in Courtroom No. , of the Cumberland County Courthouse,
Hanover and High Streets, Carlisle, Pennsylvania.
Because the minor is 12 years of age or younger, the Court hereby waives the
fingerprinting requirement in 54 Pa.C.S.A. §702 and requirement of official searches of
judgments, decrees of record, and liens in §701(a.1)(4). See 23 Pa.C.S. §5105.
Notice of Petitioner's Name Change Petition for the minor child, Michael A.
Kiner, and hearing scheduled above shall be published in two newspapers of general
circulation, one of which shall be the official paper for publication of legal notices in
Cumberland County, Pennsylvania.
Petitioner shall serve any non-petitioning parent of a child whose name may be
affected by the proceedings.
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BY THE COURT:
314
021a y1f
IN RE: : IN THE COURT OF COMMON PLEAS
PETITION FOR NAME CHANGE : CUMBERLAND COUNTY, PENNSYLVANIA
OF MICHAEL A. KINER,
A MINOR CHILD : DOCKET NO.
CIVIL ACTION - LAW
ORDER OF COURT
AND NOW, this day of
4?A-l
, 2012, upon
consideration of the within Petition and Hearing held thereon, it is hereby ORDERED
AND DECREED as follows:
1. Petitioner's request for a change of name is hereby granted.
2. MICHAEL ANTHONY KINER shall hereafter be known as
MICHAEL ANTHONY HEIN.
3. Petitioner may apply for a Certified Copy of Birth Record verifying that
the name appearing on Petitioner's birth certificate is MICHAEL-, r
ANTHONY HEIN. r r{
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BY THE COURT:
Miry G' J.
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