The URL can be used to link to this page

Home My WebLink About13-4695 NAME CHANGE-MINOR CHILD: IN THE COURT OF COMMON PLEAS Kimberly Shiley(Mother) CUMBERLAND COUNTY, PENNSYLVANIA f�/ 1C'1' Miranda Jolie Everett(Minor Child) CASE NO. 2U13 - 7 G g,S PETITION FOR NAME CHANGE—MINOR CHILD moo c--) 1 3 i TO THE HONORABLE JUDGES OF THE COURTS: =c CDC, „ This Petition,presented by Kimberly Shiley,Pro Se, formally requests that the Surname of the aforementioned Minor Child be granted change,to match that of the biological mother's Surname. The following details regard the Petition for Name Change—Minor Child; 1. Minor Child is Miranda Jolie Everett who has resided at 103 Hummel Avenue, Lemoyne, in Cumberland County,Pennsylvania, 17043 since birth. 2.Minor Child is eight(8)years old,and was born on June 17, 2005, at Penn State Hershey Medical Center in Hershey, Pennsylvania. 3.Minor Child has resided at the address listed above with mother, Kimberly Shiley, only and since birth. 4. Minor Child desires to legally change her full name to Miranda Jolie Shiley. 5.The Biological mother's name and address are as follows: Kimberly Shiley 103 Hummel Avenue, Lemoyne, Cumberland County,Pennsylvania b. The Biological father's name is Steven Allen Everett. Address is unknown. Telephone number is unknown. Biological father is not listed on child's original birth certificate. Father does not pay child support in any form or fashion. Father lost all visitation rights with child due to numerous felony charges relating to rape and sexual assault of a mirror. 7:Petitioner of Minor Child provides the following reasons for this request: a.Minor Child bears zero blood relationship to the"Everett"Surname, since her biological Father was adopted from Chile and given the Surname of Everett. b.Father abandoned Child very early.in life,leaving behind psychological and emotional scars associated with having the father's surname. c.The request of Surname change has been made by the Minor Child. d. The change of Surname would be in the best interest of the Child. 8. The proposed change in Minor Child's name,if granted,will not be detrimental to the interests of any other person,and is not going against public interest. This Petition for Change of Name—Minor Surname, is not filed as a way to defraud.creditors. WHEREFORE,the Petitioner,on behalf of the Minor Child,requests the Honorable Courts of Cumberland County,Pennsylvania,pursuant to the Act of December 16, 1982, P.L. 1309,No. 295 § 2, 54 Pa.C.S. § 701,the following: a.to fix a hearing pertaining to the requests of this Petition,as necessary; b.to direct that notice be given on this Petition,and hearing; and C. to enter a Decree legally granting the change of the Minor Child's name from: MIRANDA JOLIE EVERETT to MIRANDA JOLIE SHILEY Date Signed Kimberly Shiley,Pro Se (Petitioner) VERIFICATION -2n/ teq verify that the j facts set forth in the PETITION FOR CHANGE OF NAME-MINOR CHILD are true and correct to the best of my knowledge,information,and belief.I understand that the statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. U-L �J — ' T Date Signed b erly Shiley,Pro Se (Petitioner) NAME CHANGE-MINOR CHILD: IN THE COURT OF COMMON PLEAS Kimberly Shiley(Mother) CUMBERLAND COUNTY, PENNSYLVANIA > -O:K Miranda Jolie Everett(Minor Child) CASE NO. 2013 - 7L Ill ry c£ . NOTICE TO PROCEED WITH IN FORMA PAUPERIS 1,I am the Plaintiff I Petitioner in the above matter,and due to my financial condition I am unable to pay the fees and costs associated with the proceedings. 2.1 am unable to obtain funds from anyone,including my f*ily and associates,to pay the costs of court filing fees. 3.1 represent that the information below relating to my ability to pay the fees and costs is true and correct: (a) Name and Address KIMBERLY SHILEY 103 HUMMEL AVENUE,LEMOYNE PENNSYLVANIA 17043 (b) Employment Status ` UNEMPLOYED!DISABLED (c) Other income within the past twelve (12) months Business or Profession: N/A Self-Employment: N/A Interest and Dividends: N/A Pension and Annuities: NIA Social Security Benefits: N/A Disability Payments: $12,312.00 Unemployment Comp.: N/A Worker's Compensation: N/A Public Assistance: SNAP, MEDICAID,LIHEAP Child/Spousal Support: $0.00 Other: Voter Poll Worker(as needed only) (d) Other contributions to household support Spouse Name: N/A Spouse Employer: N/A Spouse Salary: N/A Contributions from Children.: N/A Contributions from Parents: N/A Other Contributions: N/A (e) Property Owned Cash on Hand: $18.00 Checking account: $3.66 Savings account: $0.24 Certificates of Deposit: NIA Real estate (home,rentals, etc.): N/A Motor vehicle: 2000 Ford Escort ZX2 Amount Owed on Vehicle: $0.00 Stocks and Bonds: N/A Other: NIA (f) Debts and Obligations Mortgage: N/A Rent: $650.00/mouth Loans: $29,842.00 Other: All utilities,,child care,food,household supplies e ' (g) Persons dependent upon you for Support Spouse Name: NIA Child's Name and Age: Miranda Everett; 8 years,daughter Other Persons: N/A 4. I understand that I have a continuing obligation to inform the court of improvement in my financial circumstances which would permit me to pay the costs incurred herein. S. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904,relating to unsworn falsification to authorities. ^ A 8 Kimberly Shiley,Pro Se Date Signed PRAECIPE TO PROCEED IN FORMA PAUPERIS To the Prothonotary: Kindly allow KIMBERLY SHILEY,Plaintiff/Petitioner to proceed in forma pauperis due to the inability to pay the costs that are associated with the legal proceedings, as detailed in length within the.above NOTICE TO PROCEED WITHIN FORMA PAUPERIS. Kimberly Shiley,PlaintiffJPetitioner Date Signed [nor co 0 rs bu-I y I k I' FCMO,4- pom -r CR5 E Evefe4 tiS �e-v� bn �P-A ANI � D (b k6 C 3 _+ w `T' rysj, _C "E3 C3--r' NAME CHANGE-MINOR CHILD: IN THE COURT OF COMMON PLEAS Kimberly Shiley(Mother) CUMBERLAND COUNTY, PENNSYLVANIA Miranda Jolie Everett(Minor Child) CASE NO. 2013 - q6q5- �'(M ORDER AND NOW,on this 60 day of 2013, it is hereby ordered that a hearing in the above-captioned name change matter is scheduled for the 1t*4-A day of _ , 201�, at a.m.�� 1 in Courtroom No. / , on the Floor of the Cumberland Countp r �r Courthouse, located in Carlisle,Pennsylvania. M .�,.. It is further ordered that an official search conducted by the county office waived due to the fact that the name change pertains to a minor child. Since the Father's whereabouts are unknown, and the safety of the minor child would be jeopardized,the Petitioner is granted to proceed without notification provided. BY THE HONORBLE COURTS: 3 Q NAME CHANGE-MINOR CHILD: IN THE COURT OF COMMON PLEAS Kimberly Shiley (Mother) CUMBERLAND COUNTY, PENNSYLVANIA Miranda Jolie Everett(Minor Child) CASE NO. 2013 - q(0,?� DECREE FOR CHANGE OF NAME MINOR CHILD AND NOW, on this day of ,� / ,20 l.3 ,upon full consideration before this Court, and it having been determined that the requirements of 54 Pa.C.S.A. §701 have been satisfied,it is hereby ORDERED and DECREED that the name of the Minor Child,Miranda Jolie Everett, is hereby legally changed to Miranda Jolie Shiley, and that,the Minor Child, from this date forward, shall exclusively use, and be known only by the name of MIRANDA JOLIE SHILEY. BY THE HONORABLE COURTS: -r)3 -` r n r-' .. -<>��p C • V rr3� �••-.�1.� �{V p �CD Official Seal -Required (� Z:C:) 6 n { 03 Q� A