Consent Of Parent To Name Change Of Other Parent And Waiver Of Norice
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Consent Of Parent To Name Change Of Other Parent And Waiver Of Norice Form. This is a Arizona form and can be use in Mohave Local County.
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Tags: Consent Of Parent To Name Change Of Other Parent And Waiver Of Norice, Arizona Local County, Mohave
For Clerk’s Use Only
Name of Person Filing:
____________________________________
Mailing Address:
____________________________________
City, State, Zip Code:
____________________________________
Daytime/Evening Phone Number:
____________________________________
ATLAS Number (if applicable)
____________________________________
Attorney Bar Number (if applicable) ____________________________________
Self or
Represented by
by Attorney
SUPERIOR COURT OF ARIZONA MOHAVE COUNTY
In the Matter of
Case Number:
CONSENT OF PARENT TO NAME
CHANGE OF OTHER PARENT AND
WAIVER OF NOTICE
____________________________________
Name of Applicant
(Person Requesting Name Change)
REQUIRED INFORMATION FROM PARENT, UNDER OATH OR AFFIRMATION:
1.
INFORMATION ABOUT ME:
Name: _____________________________________________________________________________
Address: ___________________________________________________________________________
Telephone: ________________________
Date of Birth: _______________________
Month
______________________
Date
__________________
Year
The applicant and I have at least one child in common.
2.
I have read the Application for Name Change and consent to changing the other parent’s LEGAL name
to new name of:
First:______________________ Middle:____________________ Last:_________________________
3.
I waive notice of all further proceedings in this matter.
OATH OR AFFIRMATION OF CONSENTING “OTHER PARENT”
STATE OF ARIZONA )
COUNTY OF MOHAVE ) ss.
The contents of this document are true and correct to the best of my knowledge and belief.
Signature: _______________________________________
Date: ______________________
Sworn to or affirmed before me on this ______________________ day of _________________, 20__________
By: ___________________________________
My Commission Expires: ______________________
1/11/2010
_____________________________________
Notary Public or Deputy Clerk
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