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 ____________________________________ Name of Applicant (Person Requesting Name Change) Case Number: CONSENT OF SPOUSE TO NAME CHANGE OF OTHER SPOUSE AND WAIVER OF NOTICE REQUIRED INFORMATION FROM SPOUSE, UNDER OATH OR AFFIRMATION: 1. INFORMATION ABOUT ME (the spouse of the applicant): Name: _____________________________________________________________________________ Address: ___________________________________________________________________________ Telephone: ________________________ Date of Birth: _______________________ Month ______________________ Date __________________ Year I am married to the Applicant (the person requesting the name change). 2. I have read the Application for Name Change and consent to changing my spouse's LEGAL name to: First: ______________________ Middle: ____________________ Last:________________________ 3. I waive notice of all further proceedings in this matter. OATH OR AFFIRMATION OF CONSENTING SPOUSE 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: _______________________ _____________________________________ Notary Public or Deputy Clerk Revised: 4/13/2011 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com