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HAROLD I. IRWIN, III, EIQUIRE
ATTORNBY' ID NO. 29820
84 IOUTH PITT ITREET
CARLlILE PA 17013
(717) 243-6090
ATTORNBY' FOR PETITIONER
IN RE: CHANGI! OF NAMI! OF
AMANDA MATZ
to AMANDA MARIE! GI!LLI!TT
: IN THE COURT OF COMMON PLEAS OF
: CUMBI!RLAND COUNTY, PENNSYLVANIA
.
.
: NO. 2005. 3"i 01 CIVIL TeRM
PETITION FOR CHANGE OF NAME
TO THE HONORABLE JUDGES OF SAID COURT:
NOW comes the petitioner, AMANDA MATZ, by her attorney, Harold S. Irwin, III,
Esquire, and presents this petition for change of name, representing as follows:
1. Petitioner is AMANDA MA TZ, an adult individual residing at 205 Taunton Drive,
Carlisle, Cumberland County, Pennsylvania 17013.
2. Petitioner was born on February 2, 1984 to John J. Matz and Gina M. Matz and
is now 21 years old. A copy of petitioner's birth certificate is incorporated herein by
reference and attached hereto as Exhibit "A".
3. Petitioner's parents are divorcing and her mother has retaken her maiden name,
"Gellett". Petitioner is residing with and being supported by her mother and desires to
change her last name to her mother's maiden nam~.
4. In addition, petitioner's middle name was mistakenly omitted from her birth
certificate and she would like to have it included on her official birth record.
5. There are no judgments or decrees of like character of record against petitioner.
WHEREFORE, petitioner requests your Honorable Court, pursuant to Act of December
16, 1982, P.L. 1309, No. 295, Section 2, 54 Pa. Cons. Stat. Section 701, et seq., to do
the following:
A. Fix a hearing on this petition;
B. Direct that notice be given of this petition; and
C. Enter a decree changing the name of petitioner from Amanda Matz to
Amanda Marie Gellett.
July ~, 2005
HAROLD S. IRWIN, II
Attorney for Petitione
VERIFICATION
The foregoing petition is true and correct to the best of my knowledge, information and
belief. I understand that false statements made herein are subject to the penalties of
18 Pa.C.S.A. Section 4094, relating to unsworn falsification to authorities.
July!..2, 2005
{)17?ard/P. jf}tr
AMANDA MATZ, Petitioner
IN RE: CHANGE OF NAME OF ; IN THE COURT OF COMMON PLEAS OF
AMANDA MATZ ; CUMBERLAND COUNTY, PENNSYLVANIA
to AMANDA MARIE GELLETT
; NO. 2005 .
CIVIL TERM
OFFICIAL SEARCH
TO THE HONORABLE JUDGES OF SAID COURT:
An official search of the records and indices in the Office of the Prothonotary,
Cumberland County, Pennsylvania, shows that there are no outstanding judgments or
decrees of record against AMANDA MA TZ.
,2005
Prothonotary
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EXHIBIT IIAII
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IN RI!: CHANGI! OF NAMI! OF
AMANDA MATZ
to AMANDA MARII! GI!LLI!TT
: IN THI! COURT OF COMMON PLI!AS OF
= CUMBI!RLAND COUNTY, PI!NNSYLVANIA
.
.
= NO. 2005 - 3<f 0" CIVIL TI!RM
ORDER FOR PUBLICATION
NOW this \ loll day of 0ill.1'1AIJ.- ,2005, upon motion of Harold S. Irwin, III, Esquire,
attorney for petitioners, i~and decreed that the within petition be heard on the
~ day of D~ , 2005, at~ o'clock ~.m. in Courtroom No. ..oL,
Cumberland County Courthouse, Carlisle, Pennsylvania, and that notice of hearing be
published in two newspapers of general circulation in this County, one of which may be
the official paper for publication of legal notices in this County.
By the C9Urt, '1
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HAROLD S. IRWIN, III, ESQUIRE
ATTORNEY ID NO. 29920
84 SOUTH PITT STREET
CARLISLE PA 17013
(717) 243-6090
ATTORNEY FOR PETITIONER
IN RE: CHANGE OF NAME OF
AMANDA MATZ
to AMANDA MARIE GELLETT
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
= NO. 2005 ..J<J" ') CIVIL TERM
DECREE
NOW, thi;L~ day of ~, 2005, upon hearing on the within petition and
on motion of Harold S. Irwin, III, Esquire, attorney for petitioner, and upon proof of
publication of notice as required by law, together with proof that there are no judgments
or decrees of record or any other matter of the like effect against Amanda Matz and it
appearing that there is no legal objection to the granting of the prayer of the petitioner,
IT IS ORDERED AND DECREED that the name of Amanda Matz is hereby changed to
Amanda Marie Gellett
By the COLl.rt, / 7
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