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In Re AIDAN MATTHEW BIRCH,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
No. 12 ..- alqO d/L ??!/L1
CIVIL ACTION
CHANGE OF NAME
PETITION TO CHANGE NAME
AND NOW comes JULIE NICHOLE CLUCK, by and through her
attorney, Thomas D. Gould, and requests this Honorable Court,
pursuant; to 54 P.S. Section 701, to issue a Decree changing the
name of her biological scn, AIDAN MATTHEW BIRCH, to AIDAN MATTHEW
CLUCK, based on the following:
1. Julie Nichole Cluck, hereinafter referred to as Mother,
resides at 1286 Timber View Drive, Mechnaicsburg, Cumberland
County, Pennsylvania 17050.
2. Raymond Matthew Birch, hereinafter referred to as Father,
whose_ast known address was 3115 Susquehanna Street, Harrisburg,
Dauphin County, Pennsylvania 17110.
3. Mother and Father are the biological parents of Aidan
Matthew Birch, born June 12, 2007, hereinafter referred to as
Child. A copy of the birth certificate is attached as exhibit A.
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#o2 36s-
11. The Mother and Father are listed on the Child's birth
cert1 ri.cate .
5. Mother previously resided with the Child at 171 S. Enola
Drive, Enola, Cumberland County, Pennsylvania 17025.
6. The best interests of Child will be served by changing
his surname to that of his Mother's because:
a. Mother has been the Child's primary care giver
throughout his life.
b. The Child's current surname is not consistent with
the surname of his primary care giver, Mother.
C. Mother believes that her son will incur unnecessary
obstacles in school and other areas if he is not given her surname.
d. Father has voluntarily chosen not to be a part of the
Child's life.
7. Child has no judgments or decrees of record or any other
matter pending of like character against him in this or any other
jurisdiction.
WHEREFORE, Petitioner respectfully requests this Honorable
Court to set this matter -or hearing and enter an Order directing
Petitioner to give Legal Notice as required by statute to all other
interested parties of the filing of this action and the date and
time set for Hearing, wh-ch shall not be less than one month or
more than three months after the filing of this Petition.
After the Hearing i_t is respectfully requested that this
Honorable Court issue a Decree changing the name of Ai.dan Matthew
Birch to Aidan Matthew Cluck.
Respectfully submitted,
71??-?
Thomas D. Gould, Esquire
Attorney For Petitioner
I.D. # 36508
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
VERIFICATION
I verify that the statements made in this Petition To Change
Name are true and correct. I understand that false statements made
herein are subject to the penalties of 18 P.S. Section 4904,
relating to unsworn falsification to authorities.
J lie Nichole Cluck
E.AA;t A
"(HIS DOCUYIFNT IS PRIN IEil ON =FCUHITY WAIFRMARKEC PAPER Y Li
WARNING:, ,.Or r,„ Er"I 'ilfFF!OU7 VE.`i1FYINr fNc P^ESFNCE OF -rHE WAIF. Ri.1ARK •*v t Y
In Re AIDAN MATTHEW BIRCH,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
No. IA- ,`1 o
erv!G 7?s/- ^I
CIVIL ACTION
CHANGE OF NAME
ORDER
11 4+
AND NOW this day of 2012, it is hereby ordered
that a hearing in the above captioned name change matter be scheduled for
the day of , 2012 at ) M. in Courtroom ,
Floor, Cumberland County Courthouse, High and Hanover Streets,
Carlisle, Pennsylvania.
It is further ORDERED that an official search of the proper offices
of any county where petitioner resided within the past five (5) years
shall be conducted. Proper certification from the Prothonotary's Office
verifying that there are no judgments, decrees of record or any other
like character against the petitioner shall be submitted at the hearing.
It is further ordered that a notice of said hearing shall be made
by one (1) publication in both the Cumberland Law Journal and in a
newspaper of general circulation in Cumberland County, Pennsylvania.
Such publication shall take place at least one (1) week prior to said
hearing. Proof of publication shall be submitted prior to or at the
hearing.
Distribution:
Thomas D. Gould,
J
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East Main Street, Shiremanstown, PA 11 ??
IN RE : NAME CHANGE MATTER
PETITION OF
AIDAN MATTHEW BIRCH .
IN THE COURT OF COMMON PLEAS
CiM33ERLAND COUNTY, PENNSYLVANIA
No. 2012 - 2140 CIVIL TERM
CIVIL ACTION
CHANGE OF NAME
ORDER
CO
rTi AND NOW this e day of Mont 2012, after Hearing,
it is hereby ORDERED and DECREED that AIDAN MATTHEW BIRCH's
f.l"li
Petition to change his name to AIDAN MATTHEW CLUCK is GRANTED and
from this day forward AIDAN MATTHEW BIRCH is to be legally known as
AIDAN MATTHEW CLUCK.
J.
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