HomeMy WebLinkAbout02-1255IN RE:
NICHOLAS WILLIAM THOMPSON,
CHANGE OF NAME
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: NO.
: CHANGE OF NAME
PETITION FOR CHANGE OF NAME
Nicholas William Thompson, by and through his attorney John H. Broujos, of Broujos and
Gilroy, P.C., sets forth the following:
1. Petitioner Nicholas William Thompson is 19 years of age, bom October 9, 1982, and
resides at 421 Potato Road, Carlisle, PA 17013.
2. Petitioner has resided at that address since 1997.
3. Petitioner has resided at:
Doubling Gap Road, Newville, PA
Enola Road, Carlisle, PA
Camp Hill, PA
4. Petitioner desires to have his name changed from Nicholas William Thompson to
Nicholas William McDonough.
5. Petitioner desires to have his name changed for the following reasons:
a. To match family line (mother's) in which he has been raised.
b. The name is that which he has used during his lifetime.
c. Nicholas William McDonough is the name that he wishes to be adjudicated in time
for the name to appear on his high school diploma at graduation in June, 2002.
6. Petitioner is a high school senior and a draftsman intern. He is emancipated. He lives
with his mother, who is unemployed and attending HACC to obtain training to increase her
capability for employment. Petitioner shares in costs of utilities and gives to his mother a
monthly sum for household expenses. His father plays no part in his life except paying $250 a
month support.
7. Changing his name would not be harmful to the rights of others or prejudicial to the
public good or to creditors.
8. There are no judgments or decrees of any nature outstanding against Petitioner.
WHEREFORE, your Petitioner prays your Honorable Court to enter a decree, changing his name
from Nicholas William Thompson to Nicholas William McDonough.
Date: ~"~ . ,'. & Z~ ~A¥-Xv~
o .. ro os,O -
BROUJOS & GILROY, P.C.
4 North Hanover Street
Carlisle, Pennsylvania 17013
717/243-4574 717/766-1690
FAX #717/243-8227
I verify that the statements made in this pleading are tree and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to
unswom falsification to authorities.
Nicholas William Thompson
IN RE:
NICHOLAS WILLIAM THOMPSON,
CHANGE OF NAME
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
:NO.
: CHANGE OF NAME
PRAECIPE TO PROCEED IN FORMA PAUPERIS
TO THE PROTHONOTARY:
Kindly allow Nicholas William Thompson to proceed in forma pauperis.
I, John H. Broujos, Broujos & Gilroy, P.C., attorney for the party proceeding in forma
pauperis, certify that I believe the party is unable to pay the costs and that I am providing free
legal services to the party. The party's affidavit showing inability to pay the costs of litigation is
attached hereto.
IN RE:
NICHOLAS WILLIAM THOMPSON,
CHANGE OF NAME
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: NO.
:
: CHANGE OF NAME
AFFIDAVIT IN SUPPORT OF PETITION
FOR LEAVE TO PROCEED IN FORMA PAUPERIS
1. I, Nicholas William Thompson, because of my financial condition am unable to pay the
fees and costs of prosecuting, defending, or appealing the action or proceeding.
2. I am unable to obtain funds from anyone, including my family and associates, to pay the
costs of litigations.
3. I represent that the information below relating to my ability to pay the fees and costs is
tree and correct.
(a) Name: Nicholas William Thompson
Address: 421 Potato Rd., Carlisle, PA 17013
(b) Social Security Number: 198-62-8939
If you are presently employed, state:
Employer: SGS Architectural Engineers
Address: 1 Tyler Court, Carlisle, PA 17013
Salary or wages per month: $350
Type of work: draftsmen intern; part-time after school
I am a senior in Big Spring High School.
My mother is unemployed and attending HAAC.
I have no contact with my father.
(c) Other income within the past twelve months
Business or profession: N/A
Other self-employment: N/A
Interest: N/A
Dividends: N/A
Pension and annuities: N/A
Social Security benefits: N/A
Support payments: $ 250/mo.
Disability payments: N/A
Unemployment compensation
and supplemental benefits: N/A
Workman's compensation: N/A
Public Assistance: N/A
Other: N/A
(d) Other contributions to household support
Wife/Husband Name: N/A
If your wife/husband is employed, state N/A
Employer:
Salary or wages per month:
Type of work:
Contributions from children:
(e) Property owned
Cash: $ 40
Checking Account: N/A
Savings Account: $ 800
Certificates of Deposit: N/A
Real Estate (including home):N/A
Motor vehicle: Make: Ford Aerostar
(f)
Stocks; bonds:
Other:
Debts and obligations
Year: 1987
In joint name with mother
Cost: $1200; shared with mother.
N/A
N/A
Owed: N/A
(g)
Mortgage: N/A
Rent: N/A
Loans: N/A
Monthly Expenses: $150
Persons dependent upon you for support
Wife/Husband Name: N/A
Children, if any: N/A
What money I make goes to helping my mother with household expenses and my living
expenses.
4. I understand that I have a continuing obligation to inform the court of improvement in
my fmancial circumstances which would permit me to pay the costs incurred herein.
5. I verify that the statements made in this affidavit are tree and correct. I understand
that false statements herein are made subject to the penalties of 18 Pa.C.S. 4904, relating to
unswom falsification to authorities.
DATE:
Nicholas William 'l;horn~son
DATE: '27 x'g, O--'~-
R~l~full3~ed,
BROUJOS & GILRO¥, P.C.
4 North Hanover Street
Carlisle, Pennsylvania 17013
717/243-4574; 717/766-1690
FAX# 717/243-8227
AGE [ DATE OF BIRTH DOB
LEAV BLANK
$. R. LITTLE
lo [. LITTLE
LEFT FOUR ~ERS TAKEN SI
IN RE:
NICHOLAS WILLIAM THOMPSON,
CHANGE OF NAME
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
::NO. 0.2. la ~ ~' ~1 "-'[-o-~-
: CHANGE OF NAME
ORDER
AND NOW, this /5.0] day of '~7~ ,2002, upon consideration of the foregoing
Petition for Change of Name, the Court hereby fixes the ~ day of ~f_~, 2002, at
~ ;~/) a..m., in Court Room No. %/ , as the time and place for hearing of Petition when and
where all persons interested may appear and show cause, if any they have, why the prayer of said
Petition should not be granted.
BY THE COURT,
J
IN RE: NICHOLAS WILLIAM
THOMPSON
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
02-1255 CIVIL
CIVIL ACTION - LAW
NAME CHANGE
ORDER
AND NOW, this 'Z 0 ~ day of March, 2002, upon request of counsel, the hearing in
the above captioned name change petition set for May 3, 2002, is rescheduled to Monday, April
29, 2002, at 10:30 a.m. in Courtroom Number 4, Cumberland County Courthouse, Carlisle, PA.
BY THE COURT,
John Broujos, Esquire
For the petitioner
Hess, J.
:rim