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Home My WebLink About05-4172 IN THE MATTER OF APPLICATION . IN THE COURT OF COMMON PLEAS FOR CHANGE OF NAME OF ANDREW. OF CUMBERLAND COUNTY, PENNSYLVANIA PHILLIP RIOS, A MINOR, BY DENNIS : ~ T. RIOS, GUARDIAN AND MICHELLE: NO. DS; - 41 "/ ~ Ct'w i.L I tJ2..}-"},'1 K MOYER, CO-APPLICANT l : CIVIL ACTION - LAW APPLICATION FOR CHANGE OF NAME 1. Applicant is Andrew P. Rios, a minor, by Dennis T. Rios, Guardian. 2. Dennis T. Rios is the biological father of Andrew P. Rios. He resides at 3105 Oak Grove Road, North Little Rock, Arkansas 72118. 3. Co-Applicant is Michelle K Moyer who is Andrew's maternal aunt. 4. The biological mother of Andrew P. Rios is Pammalla L Howe who died on October 2, 2004. See Exhibit "A". 5. From October 31,2004 to the present, Andrew has resided with Michelle K Moyer at 1533 Main Street, Mechanicsburg, Cumberland County, P A 17055. 6. At the time the undersigned prepared this application, it is anticipated that shortly a Custody Order will be entered in the Cumberland County, Pennsylvania Court of Common Pleas which grants to Michelle K Moyer certain custody rights to Andrew. 7. Previously and for the past 5 years Andrew has resided as follows: a. From April 2001 to October 31, 2004, Andrew resided at 5101 East Twain Avenue, #131, Las Vegas, Nevada 89122. Andrew resided with Pammalla L Howe, his mother, Patricia G. Howe, his aunt and Richard W. Howe, his uncle. b. From approximately 1993 to April 2001, Andrew resided at 3001 Cabana Drive, Lot G 350, Las Vegas, Nevada 89121. Andrew resided with Pammalla L Howe, Patricia G. Howe, Richard W. Howe and Helen J. Howe, his maternal grandmother. 1 8. It is not anticipated that any judgments have been entered against Andrew in any County where he resided for the past 5 years. At the hearing set in this matter applicant intends to admit into evidence proof of the same from Cumberland County, Pennsylvania and Clark County, Nevada. 9. It is not anticipated that Andrew has a criminal conviction on his record and evidence of the same will be presented at the hearing to be held in this matter. 10. For the foregoing reasons it is important for the name of Andrew Phillip Rios to be changed to Andrew Phillip Howe: 1. Andrew cannot get a drivers license because the name on his social security card (Howe) differs from the name on his birth certificate (Rios); 11. Since Andrew was between 2 and 4 years old, he has always used the last name Howe; 11L Andrew feels more comfortable using the last name Howe. WHEREFORE, Applicant and Co-Applicant request the Court issue an Order directing that Andrew's legal name be changed to Andrew Phillip Howe from Andrew Phillip Rios. YOFFE & YOFFE, PC Je frey . Yoffe, E quire Attorney for Michelle K. Moyer 214 Senate Avenue, Suite 203 Camp Hill, PA 17011 (717) 975-1838 Attorney ID No. 52933 jyoffe@verizon.net 2 VERIFICATION AND CONSENT I hereby state that I am an adult individual who is authorized to make this verification and that the facts set forth in the foregoing Application for change of name are true to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. 94904 relating to unsworn falsification to authorities. I have reviewed the foregoing application for change of name of Andrew Phillip Rios and I hereby consent to the relief being requested therein. Andrew Phillip Rios Dated:X & - ICj. oS- ByX {I-A~ Dennis T. Rios, Guardian 3 VERIFICATION AND CONSENT I hereby state that I am an adult individual who is authorized to make this verification and that the facts set forth in the foregoing Application for change of name are true to the best of my knowledge, information, and belief. I understand that false statements herein are made subj ect to the penalties of 18 Pa. C.S. ~4904 relating to unswom falsification to authorities. I have reviewed the foregoing application for change of name of Andrew Phillip Rios and I hereby consent to the relief being requested therein. Dated: (~MAIYJ.Jr Michelle K. Moyer 4 DEPARTMENT OF HEA~ TH AND HI)MAN SERVICES SOCIAL SECURITY ADMINISTAA TION rorm Apprtlvld OM6 No. 0geO-O'42 STATEMENT OF DEATH BY FUNERAL DIRECTOR NAME OF DECEASED I I L .J P..... compl.'. tha item, below. and rewrn the larm In the enclosed 8ddrwsted, po..age pakt envelope. Your ani.'ance and oooprttatlon ar. apprec;ialed. PAPERWORK ACT NOTICE: Tho InformaliOn onw. 101m i. aulnOlfudby ..clonH04,7'5""d4D4.720 01 Feoe,.1 RaoUlllians (20 CFA 404.115 ond 404.720), Whl. your ...pan.. ilVoNr*.ry, wa n..O your u.lllanceto "".1 an accu... andlim.ty dII.rtrJre'lon concernlnu 'hi d.a1h 01 the individuAl n.mod .bOY., and 10 doll"",,," ., Ill,,", a,.IUnINO,. who may ~ .ltglblllor Social 90eurily bono'"o. Wa moy 1110 u. "'lnto_~n you gill. ...When w. mMch "'001<11 by..lI'4'UItr. MatclllngplVorll'l' ..mpore our IlIcord. wilh 1I10...f 0111.. F.d...." Slall. Of 10.., go..mmenllll."dae. Many IQtnd.. mlY _ M&ICl\lno prog..m. 10 find.. provalhat. pollOn quI/II.. fIlr bollll!> plld by IlII F.d....J gov.n....l. Tho Ill.. a1towa "*10 dll thIo._ Kyou do IlOlalJl. 10 it. ~p&ln.taon. .bEI" 1h..1tId Dlher I'llIOn. why lnforrreUQn you pwoW:le UI m.y bluaed Or uN-In OUl... Ivailabkt in Social Security I)ffices. If you wane " ..... nil,. .....1 "10. o;onllclanv So...1 Se....tly 011IoI. TI/II IT TAKEI 'JO COIII~111I lMII '01'1" Wollli"... IIllliwl.t....VoullbouI3.~ mlnUII.lo oompltlll!lla form. Thislnelu".. Ih.tlma ~w~..."'1o ..Ill tile lnoltuctions. gilll.rtll. noe..../Y fat" and II olot .. 'orm. II )IOu *-W oomrrentl Qr IUliliHtiOfll; on "'1, .stim.., or Ol't ''''Y other upec:t of th. 10"", 'flItl. ., U,. Social SlelJrity Admini....tion. ATTN: fllpooII ClIa..._ Oh,. '.A.2' Opo",lIo.. Bide.. Ilaltlmllll. "'D 21235410'. and II> In. 011I.. 0' ManllJ..".n'....d BUdgo.. PIlporworl< __ ProjlClIOll80-lI'38). Wuhlngton. D.C. 20503. land only commanll ,.'.Ung 10 our ..U..... or olll.. ..pa.. 011/1I. lOml to tIIot .If.... Ill.... .0... All ......... lot 'ocllllacurJ!y .-de an" oIMr CI.lm....I..... Inloml.lon .hould bo IIn'lO ,our locel Social ,"curtlY olftcl, whoa. .oIre. II hl.d In your "'I",hon. d'rM'ory undo<..o D.parln\.n, 01 Hea'''' .nd Humltl """0.. '. NAME F DECEASED ~ 2. ~9'A1. SECU~T)' NUM~ER CJ Ao'f ~2,2j.Y61 4'JJ.J. J. DATE OF DEATH 4. DATE OF IIIRTH (I1_no...) 101 ~f 5. Ch.... (....) wfllth" Iho cIeCIUod.... OMI" ~.Io S. NAME OF WIDOW OR WIDOW"" 4~ ,. AODRESS (No. and Sir... P.O. iklk) OF WIDOW OR WIDOWER I" wwnl .57{)J E #;$/ CITY STATE ZIP CODE Lf/J fc?,I.:4.P--' Farm ......,., "Qt, n..1IIw..... MMftM. e-- EXHIBIT "A" ~ t; N::l ~. ~ ~ 4- CY --v <r, v D :If- ....... ~ ~ ~ . " Ql ~ 1- ~ - ~ ~p:! -1 ~ Q, C) I..-:;::.t C,~ 01 :::t '" 2: (11 f: G~') -0 j'" :01:( tfI '3 S:?, _l- -f1 "-,~ -0 C) B :.,:;' :,;_:;fYl C'~ S c.~~ :n ~-'l '" '< .....- (,;J RECEIVED t.", 6 1005 (f' --\ IN THE MATTER OF APPLICATION : IN THE COURT OF COMMON PLEAS FOR CHANGE OF NAME OF ANDREW: OF CUMBERLAND COUNTY, PENNSYLVANIA PHILLIP RlOS, A MINOR, BY DENNIS : T. RIOS, GUARDIAN AND MICHELLE : NO. K MOYER, CO-APPLICANT oS - /.,t7~ (!/'u,' ( '-r ~ : CIVIL ACTION .. LAW ORDER SCHEDULING HEARlNG AND NOW, this /f -t;If day of {,tuau~ , 2005, it is hereby tl Ordered that a hearing on the application for change of name filed in this matter, shall be held at <f; tfl ~\p.m on (/J(I~A~ /~ ,2005. The hearing shall be held in Courtroom No. 'f in the Cumberland County, Pennsylvania Courthouse located at I Courthouse Square, Carlisle, Pennsylvania 17013. BY THE COURT -'1~ 71d / I j""'l" ......"l,,~:i,..\ "1":-i'I\\'';-o.,\,."..~ d'\ \,',\ '~' i I d' '.,,,:<?,:-N'.;..J \ \~\r'\-i" - !\.JJ'" '," "'t":t, \\6 '6 \ 'J\\~ c..~\\~ .,." -:l"\ JD ,t"';UlV~n,,.l'(\)o :,l ~U~1.v"\")' ',;.. '(\:r\-\ , j:J,y,'....t. "-,~ \ ~ IN THE MATTER OF APPLICATION : IN THE COURT OF COMMON PLEAS FOR CHANGE OF NAME OF ANDREW: OF CUMBERLAND COUNTY, PENNSYLVANIA PHILLIP RIOS, A MINOR, BY DENNIS : TRIOS, GUARDIAN AND MICHELLE :NO. 05-4172 K. MOYER, CO-APPLICANT : CIVIL ACTION - LAW ORDER CHANGING NAMES AND NOW, this 12th day of October, 2005, in consideration of the Application to change the name of Andrew Phillip Rios to Andrew Phillip Howe, it is hereby Ordered that the individual now known as Andrew Phillip Rios shall from this point forward be named Andrew Phillip Howe. BY THE COURT ~L VIN A. HESS J. coyy t ~y(f\ \-0 y~~ lO-i;J 'OS' () '" () = c ~ -., (,;,fl co (>.;, -; f" ... 1..0