SUPERIOR COURT OF ARIZONA PINAL COUNTY In the Matter of: CASE NUMBER: CV2 ORDER CHANGING NAME OF A MINOR CHILD A Minor HONORABLE: THE COURT FINDS: 1. 2. 3. 4. This case has come before this Court to Change the Name of the minor child listed above. This Court has jurisdiction to change the name of the minor child. Good cause exists to grant the application for Change of Name. It is in the best interest of the minor child to change his/her name as set forth below. IT IS HEREBY ORDERED: 1. That the legal name of the minor born this date (month / date / year): Born in this place (city / state /nation): Whose mother is: (First) (Middle) (Last) IS CHANGED FROM: Name on Birth Certificate (First) (Middle) (Last) TO: NEW NAME (First) (Middle) (Last) 2. For the person born in the State of Arizona, the Office of Vital Records is ordered to amend the birth record to reflect the new name as ordered above. Note that except for correction of error, a woman's maiden name as recorded on the birth record, is unaffected by an order for Change of Name (or by marriage) For the person born in a state other than Arizona, to the extent that the agency that maintains birth records in that state is authorized to honor an order of this Court, that agency is requested or ordered to amend its birth record to reflect the new name(s) as ordered above. Page 1 of 2 CV_OCNM_COSCPinal_04.09.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com 3. 4. This Order does NOT establish paternity or add the name of a father to a birth certificate. This Order does not release the persons named above from any obligations incurred or harm any rights of property or action in any original name. Other Orders: 5. *May NOT be used to establish paternity or to add the name of a father to a birth certificate. DONE IN OPEN COURT this day of 20 (Superior Court Judge/Special Commissioner) Page 2 of 2 CV_OCNM_COSCPinal_04.09.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com