Application For Change Of Name Of Minor {21.2}

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 MINOR [R.C. 2717.01] The applicant states that the applicant is the [ ] parent [ ] legal guardian [ ] guardian ad litem of the minor and that the minor has been a bona fide resident of GEAUGA COUNTY, Ohio, for at least one year immediately prior to the filing of this application. A certified copy of the minor's birth certificate is attached. [] The applicant states that the name and address of the mother of the minor is: Name Address City [] State Zip and the name and address of the father or alleged father of the minor is: Name Address City State Zip [] Applicant states that the address of the [ ] mother [ ] father or alleged father is unknown and cannot with reasonable diligence be ascertained. [] There is no person alleged to be the father of said minor. The applicant states that the person for whom a change of name is being requested 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. 21.2 APPLICATION FOR CHANGE OF NAME OF MINOR Rev 2012 American LegalNet, Inc. www.FormsWorkFlow.com The applicant requests a change of name of the minor 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 thirty (30) days before the hearing on this application. In addition, notice will be given by the applicant to any non-consenting parent or alleged father, whose addresses are known, by certified mail, return receipt requested. Attorney for Applicant Applicant's signature Typed or Printed Name Typed or Printed Name Address Address City State Zip City State Zip Phone Number (include area code) Attorney Registration No. Phone number (include area code) 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 well as certified mail service, return receipt requested, if necessary, required by law. Judge Timothy J. Grendell By: Deputy Clerk American LegalNet, Inc. www.FormsWorkFlow.com