Name of Person Filing: Street Address: City, State, Zip Code: Telephone Number: Email Address: ATLAS Number (if applicable) Representing Self (No Attorney) If Attorney, Bar Number: or Represented by Attorney SUPERIOR COURT OF ARIZONA PINAL COUNTY In the Matter of: CASE NUMBER: CV2 CONSENT OF PARENT TO NAME CHANGE OF A MINOR CHILD AND WAIVER OF NOTICE A Minor HONORABLE: REQUIRED INFORMATION FROM PARENT, UNDER OATH: 1. INFORMATION ABOUT ME: Name: Address: Telephone: Date of Birth: Place of Birth: I am the natural I am the adoptive 2. MOTHER or MOTHER or FATHER of the minor child named above. FATHER of the minor child named above. I have read the Application for Name Change and consent to changing the child's name to: 3. I waive notice of all further proceedings in this matter. Page 1 of 2 CV_CPNCM_COSCPinal_04.09.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com OATH OF THE PARENT STATE OF ARIZONA PINAL COUNTY ) ) ss. ) I have read, understood, and completed the above statements. Everything I have said is true and correct to the best of my knowledge, information and belief. (Signature) SUBSCRIBED AND SWORN TO before me this day of 20 By My Commission Expires: (Deputy Clerk/Notary Public) Page 2 of 2 CV_CPNCM_COSCPinal_04.09.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com