SUPERIOR COURT OF ARIZONA PINAL COUNTY In the Matter of: CASE NUMBER: CV2 ORDER CHANGING NAME OF AN ADULT Name of Applicant HONORABLE: THE COURT FINDS: 1. 2. 3. 4. This case has come before this Court to Change the Name of the Applicant above. This Court has jurisdiction to change the name of the Applicant. Good cause exists to grant the application for Change of Name. It is in the best interest of the Applicant to change his/her name as set forth below. IT IS HEREBY ORDERED: 1. The name on the Birth Certificate OR (First) the Current Legal Name: (Middle) (Last) Date of Birth: Place of Birth: IS CHANGED TO: (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. 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 records to reflect the new name as ordered above. 3. This Order does not release the Applicant from any obligation or harm any rights of property or action in any original name. 4. Other orders: DONE IN OPEN COURT this day of 20 (Superior Court Judge/Special Commissioner) Page 1 of 1 CV_ONCA_COSCPinal_04.09.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com