The URL can be used to link to this page

Home My WebLink About12-3861 j-i, 19 P11111 It: IN THE COURT OF COMMON PLEAS In re: Name Change of CUMBERLAND COUNTY, PENNSYLVANIA KAITLYN LAREE BURTNER, : a minor : NO. PETITION FOR NAME CHANGE OF MINOR AND NOW comes Petitioner, Jennifer S. McClure, by and through her attorney, Kathy M. Shughart, and files this Petition For Name Change of Minor and in support thereof avers as follows: I . Petitioner, Jennifer S. McClure (hereinafter referred to as "Mother") is an adult individual residing at 4909 Shasta Way, Mechanicsburg, Cumberland County, Pennsylvania. 2. The subject minor child is Kaitlyn Laree Burtner, born February 4, 2003, and residing at 4909 Shasta Way, Mechanicsburg, Cumberland County, Pennsylvania. 3. Mother is the natural mother of the subject minor child. 4. Natural Father of the subject minor child is George M. Burtner, whose last known address is 904 Louisa Lane, Mechanicsburg, Pennsylvania. 5. Mother has sole legal and physical custody of the minor child pursuant to an Order of Court dated January 26, 2012 which incorporates the Stipulation For Custody e?.3.7s 1P d Order dated November 23, 2011. A true and correct copy of the Order is attached hereto and incorporated by reference herein as Exhibit A. 5. The Order provides in Paragraph I of the Stipulation that Mother "...shall be entitled to legally change the name of the minor child without consent of or notification to Father." See, Exhibit A. 6. Father has consented to the name change for the subject minor child by his agreement and execution for the Stipulation For Custody Order which allows Mother to change the name of the subject minor. See Exhibit A. 7. Mother intends to change the name of minor child to Kaitlyn Laree McClure. 8. Mother desires to change the name of the minor child to mirror her own name since Father has determined to have no role in the life of the minor child and she is the sole caretaking parent. She desires that the minor child's name be consistent with her own to avoid unnecessary confusion and questions with regard to the absence of the other parent of the minor child. 9. Mother and subject minor child have resided at the same address since the birth of the subject minor child. 10. Mother requests that the subject minor child's name be changed from Kaitlyn Laree Burtner to Kaitlyn Laree McClure by Order of Court pursuant to 54 Pa.C.S. §702(b)(5)(iii). 11. In the alternative, Mother requests a hearing be held on the issue of change of name of the subject minor child's from Kaitlyn Laree Burtner to Kaitlyn Laree McClure by Order of Court pursuant to 54 Pa.C.S. §701. WHEREFORE, Petitioner requests this Honorable Court to change the name of Kaitlyn Laree Burtner to Kaitlyn Laree McClure. Respectfully submitted, Kathy XVShughai1q. ) Attorney for Petitioner ` P.O. Box 6315 27 South Arlene Street Harrisburg, PA 17112-0315 (717)540-5114 Supreme Court #39779 T JENNIFER S. McCLURE, Plaintiff V. GEORGE M. BURTNER, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA im rn NO: ) ' -r -v rn c.- ?^ -cJ1 ?'1 `i Civil Action - Custody ORDER - " J AND NOW, this (Q day of 2012, upon consideration of Stipulation for Custody Order dated November 23, 2011 and executed by the parties, it is hereby ORDERED and DECREED that the annexed Stipulation be made an Order of the Court. BY THE COURT: Distribution: „ --F,- TRUE COPY FROM RECORD In Testimony whereof, I here unto set my hand and tt?asgal of said Court at Carlisle, Pa. This day-""-prothonotary of 20 lz? 'e- Kathy M. Shughart, Esquire, P.O. Box 6'A5, Harrisburg, PA 17112 George M. Burtner, 904 Louisa Lane, Mechanicsburg, PA 17050 EXHIBIT A I ,,? yo L ?. I r-o d rnrnw c_ a? ? N STIPULATION FOR CUSTODY ORDER ° ?`r~ THIS STIPULATION is made this 3 day of 2011,1??nd between, JENNIFER S. McCLURE, formerly known as Jennifer S. Burtner, (hereinafter referred to as "Mother") and GEORGE M. BURTNER (hereinafter referred to as "Father") WHEREAS, Mother and Father are the natural parents of minor child, KAITLYN LAREE BURTNER, born February 4, 2003; and WHEREAS, the parties desire to act in the best interest of the minor child; and WHEREAS, the parties desire to settle and resolve the questions of custody of the minor child; NOW THEREFORE, it is agreed and stipulated by the parties as follows: Mother shall have sole legal and physical custody of the minor child. She shall be entitled to make all important decisions concerning the minor child, including such matters as health, education and religion, without notification to Father. She shall be entitled to legally change the name of the minor child should she so desire without consent of or notification to Father. She shall be entitled to obtain a passport for the minor child without Father. 2. Father shall have no legal or physical custodial rights and hereby waives any custodial or parental rights he may have under the law. It is Father's stated desire that his parental rights shall be deemed to be voluntarily terminated. Father further agrees to cooperate and consent in the future should Mother remarry and desire that her new husband adopt the minor child. 4. The parties hereby waive the requirement of Rule 1915.7 requesting that they and the minor children be present before the Court to present this Stipulation and further intend this Stipulation be entered as an Order of the Court of Common Pleas of Cumberland County, Pennsylvania, subject to modifications as provided by law. 5. The parties acknowledge that all have sought or have been advised of their right to seek independent legal counsel. The parties acknowledge that Mother, Jennifer rn 'L7 i"T1 CD C; -4C:, =--r, Uri S. McClure, is represented by Kathy M. Shughart, Esquire, and that Father, George P. Burtner, has not been represented by Kathy M. Shughart, Esquire. Father specifically acknowledges that he has every right to contact his own counsel, be advised by them and review in detail the contents of this Stipulation before its execution. Father acknowledges that it is his settled desire to waive all of his custodial and parental rights with respect to the minor child. 6. This Stipulation shall supersede any and all other Orders, Agreements or Stipulations, including, but not limited to, the Stipulation dated November 29, 2005, concerning custody and visitation of said minor child which may have been made heretofore. WITNESS our hand and seal the day and year first above written. WITNESS: S m Je fer S. cClure "4 j & '? 4'9L.') - f xo'? George . Burtner ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN On this, the Z,3ra day of N&werN)aer , 2011, before me, a Notary Public, the undersigned officer, personally appeared Jennifer S. McClure, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and did declare that said instrument was executed as her free and voluntary act for the purposes therein expressed. Notary Public LNWBAj$SOF>'BASnVANA NOTARIAL, SEAL 2 nA.TPoft Notary Public mar ?y 30,2015 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CU M15 -A L,0 u/) On this, the 14*1 day of 64n134--X2 , 2011, before me, a Notary Public, the undersigned officer, personally appeared George A Burtner, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and did declare that said instrument was executed as her free and voluntary act for the purposes therein expressed. COMMONWEALTH OF PENNSYLVANIA Notarial Seal Susan Ifty Rostls, Notary Publk Hampden TWp., Cumberland County My Commission June 21 2015 MEMBER, PENNSYLVANIA ASSOCIATION OF WrARIES c?Gtla dil e?? ? S ?-'J Notary Public 3 VERIFICATION I verify that the statements made in the attached pleading are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. 'JJJeff*eer,,cClure, Petitioner IN RE: NAME CHANGE OF KAITLYN LAREE BURTNER, a minor L WW#WOA 44112t %ALA INIW IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY No. 2012-3861 CIVIL TERM IN RE: PETITION FOR NAME CHANGE OF MINOR ORDER OF COURT AND NOW, this 26"' day of June, 2012, upon consideration of the Petition for Change of Name, filed by Jennifer S. McClure on behalf of her minor child, Kaitlyn Laree Burtner, a hearing on the petition is scheduled for 2 August 2012, at 2:30 p.m. in Courtroom Number 4, Cumberland County Courthouse, Carlisle, Pennsylvania. IT IS FURTHER ORDERED that notice of the filing of said Petition and the aforesaid date, time, and place of the hearing be published once in the Cumberland Law Journal and a newspaper of general circulation in the County at least 10 days prior to the hearing; in addition, Petitioner shall comply with all other requirements of C.C.R.P. 5, and the Act of December 16, 1982, P.L. 1309, §6 (see 54 Pa. C.S. §701 [Historical and Statutory Notes] [Main Volume]), and 54 Pa. C.S. §§701 et. seq. IN ADDITION, notice of the petition and time and place of the hearing shall be provided to the child's other parent by Petitioner at least 10 days prior to the hearing by regular mail and by certified mail to his last known address. Proof of such service shall be filed of record prior to the hearing. By the Court, ? dINYAQ 1 dllnO' t CS ;C Kd 9Z Nflr 1117 Thomas A. Placey C.P.J. AUVIt QN1a ! .310 301 - ' Distribution List: i/ Kathy M. Shughart, Esq. P.O. Box 6315 27 South Arlene Street Harrisburg, PA 17112 For Petitioner, on behalf of minor child COPY made-,( Pj1c IN RE: NAME CHANGE OF KAITLYN LAREE BURTNER, A minor IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY No. 2012-3861 CIVIL TERM IN RE: PLAINTIFF'S MOTION FOR CONTINUANCE q el* ORDER OF COURT AND NOW, this 80day of August 2012, upon consideration of the Plaintiff's Motion for Continuance on the Petition for Change of Name, filed by Jennifer S. McClure on behalf of her minor child, Kaitlyn Laree Burtner, the request for a continuance is GRANTED and the hearing is rescheduled for 10 October 2012, at 1:30 p.m. in Courtroom Number 6, Cumberland County Courthouse, Carlisle, Pennsylvania. IT IS FURTHER ORDERED that notice of the filing of said Petition and the aforesaid date, time, and place of the rescheduled hearing be published once in the Cumberland Law Journal and a newspaper of general circulation in the County at least 10 days prior to the hearing; in addition, Petitioner shall comply with all other requirements of C.C.R.P. 5, and the Act of December 16, 1982, P.L. 1309, §6 (see 54 Pa. C.S. §701 [Historical and Statutory Notes] [Main Volume]), and 54 Pa. C.S. §§701 et. seq. IN ADDITION, notice of the petition and time and place of the rescheduled hearing shall be provided to the child's other parent by Petitioner at least 10 days prior to the hearing by regular mail and by certified mail to his last known address. Proof of such service shall be filed of record prior to the 10 October 2012 hearing. B t Thomas lacey C.P.J. Distribution List: ? Kathy M. Shughart, Esq. P.O. Box 6315 27 South Arlene Street - Harrisburg, PA 17112 _ For Petitioner, on behalf of minor child = f . e0j0o c-s M4. le ??? -