SUPERIOR COURT OF CALIFORNIA COUNTY OF YUBA 215 FIFTH STREET, SUITE 200 MARYSVILLE CA 95901 (530) 749-7600 CONFIDENTIAL CLETS/CJIS INFORMATION SHEET [California Code of Civil Procedure § 1279.5] Case Name: Case Number: EACH ADULT PARTY WHO IS SEEKING TO CHANGE HIS/HER NAME MUST COMPLETE AN INFORMATION SHEET, WHICH MUST BE RETURNED TO THE COURT WITH THE NAME CHANGE PETITION. YOUR CASE WILL NOT BE SET FOR HEARING UNTIL THE FORM IS PROVIDED TO THE COURT. Name: Last Address: Street Address Date of Birth: SSN: City State Zip Code First Middle Driver's License No: State of Issuance: California Code of Civil Procedure § 1279.5 requires that the court shall "use the California Law Enforcement Telecommunications System (CLETS) and the Criminal Justice Information System (CJIS) to determine whether or not an applicant for a name change is under the jurisdiction of the Department of Corrections or is required to register as a sex offender pursuant to Section 290 of the Penal Code." Yuba County Superior Court 4/09/07 _________________________________________________________________________________________________ G04050B CONFIDENTIAL CLETS/CJIS INFORMATION SHEET [California Code of Civil Procedure § 1279.5] American LegalNet, Inc. www.FormsWorkflow.com