Application For Change Of Name Of Adult {21.0}

Reset Form Print Form PROBATE COURT OF GEAUGA COUNTY, OHIO IN RE: CHANGE OF NAME OF (Present Name) To (Name Requested) Case No. APPLICATION FOR CHANGE OF NAME OF ADULT [R.C. 2717.01] The applicant states that the applicant is an adult and has been a bona fide resident of GEAUGA COUNTY, Ohio for at least one year immediately prior to the filing of this application. The applicant requests a change of name from to for the following reason: ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ The applicant states that the applicant will cause notice of the application to be published once in a newspaper of general circulation in this county at least (30) days before the hearing on this application. The applicant states that the applicant 1) ____ ___has ___ has not been convicted of, pleaded guilty to, or been adjudicated a delinquent child initials for identity fraud. 2) ____ ___has ___ has no duty to comply with ORC 2950.04 or ORC 2950.041 because the applicant initials was convicted of, pleaded guilty to or was adjudicated a delinquent child for having committed a sexually oriented offense or a child-victim oriented offense. Applicant's signature Typed or Printed Name Address State Zip City State Zip Attorney for Applicant Typed or Printed Name Address City Phone Number (include area code) Attorney Registration No. Phone number (include area code) 21.0 APPLICATION FOR CHANGE OF NAME OF ADULT Rev 2012 American LegalNet, Inc. www.FormsWorkFlow.com JUDGMENT ENTRY SETTING HEARING AND ORDERING NOTICE The Court orders this application set for hearing on the at o'clock day of , 20 , .M. The applicant is ordered to cause notice of the application to be given by one publication in a newspaper of general circulation in this county at least thirty (30) days prior to the hearing date as required by law. Judge Timothy J. Grendell By: Deputy Clerk American LegalNet, Inc. www.FormsWorkFlow.com