ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO.(Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PETITION OF (Name of each petitioner): JUDGE/DEPT CASE NUMBER APPLICATION AND DECLARATION IN SUPPORT OF REQUEST TO DISPENSE WITH NOTICE TO MINOR'S PARENT ­ NAME CHANGE I, (name) , declare: 1. I am the mother father of a minor child currently named, born on, 2. I am requesting the minor's name be changed to: for the reason specified on the Attachment to Petition for Change of Name (JC Form #NC-110). I request that the court not require notice to the minor's other parent as I am unable to locate him/her. The minor's other parent's name is: 3. The last time I saw the minor's at (location): 4. The last time I spoke with the minor's 5. The mother's father's mother father was on mother father was on: . . . . current or last known address is: . 6. The mother's father's current or last known employer and employer's address is: . 7. My minor child's grandparents on the other parent's side of the family are (name(s) and address(es)): . 8. The last time I spoke with the grandparents on the other parent's side of the family was on (date): 9. My minor's child's aunts and uncles on the other parent's side of the family are (name(s) and address(es)): . . Continued on Attachment 9 (Check the box and attach a list with additional relatives, titled "Attachment 9," to this application.) SDSC CIV-256 (New 2/10) APPLICATION AND DECLARATION IN SUPPORT OF REQUEST TO DISPENSE WITH NOTICE TO MINOR'S PARENT ­ NAME CHANGE Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com PETITION OF CASE NUMBER 10. There is, or was, a custody case (case name): In (county): 11. There is, or was, a support case (case name): In (county): Case Number: Case Number: 12. List attempts made to locate or contact the minor's other parent. (Include information on when the attempts were made, how they were made, and the results of each attempt.) 13. I attempted to do an Internet search? Yes No. Please list the results of your search, or explain why you did not make any attempt to locate the other parent on the Internet. 14. I checked public records. (For example, did you attempt to find the minor's other parent using applicable city directories, checking records at the Recorder's Office, the Real Property listing, the Fictitious Business Index, the Marriage Index, or the Superior Court Index?) Yes No. Please list the results of your search, or explain why you did not make any attempt to locate the other parent using public records searches. I exercised reasonable diligence and made exhaustive attempts to locate the minor's other parent as required by law. I submit this application as documentation of the diligence I exercised to locate the minor's other parent. Given this, I believe that the minor's other parent cannot be located and I request that I be allowed to dispense with notice to him/her. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature Number of pages attached (if any). SDSC CIV-256 (New 2/10) APPLICATION AND DECLARATION IN SUPPORT OF REQUEST TO DISPENSE WITH NOTICE TO MINOR'S PARENT ­ NAME CHANGE Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com