County Court District Court __________________________________ County, Colorado Court Address: IN THE MATTER OF THE PETITION OF: FOR A CHANGE OF NAME TO: COURT USE ONLY Case Number: Division ORDER FOR CHANGE OF NAME (ADULT) Courtroom The Court having read and considered the Petition for Change of Name finds: 1. That the statements made satisfy the statutory requirements. 2. That the desired change of name is proper and not detrimental to the interests of any other person. 3. That the Petitioner has submitted the documentation required in §13-15-101(b), C.R.S. from the Fingerprintbased Criminal History check or has provided appropriate certified copies of any dispositions that would constitute a felony conviction in this state or any other state or under federal law. THE COURT ORDERS: 1. That the name of _________________________________________________________________________ is changed to ___________________________________________________________________________. 2. That pursuant to statute, public notice of this change of name shall be published three times in a legal newspaper published in this county. This publication is to be made within 20 days of the date of this order. Proper proof of publication shall be filed with the clerk of the court upon final publication. BY THE COURT: Dated: ___________________________ JDF 434 R7/02 _____________________________________ Judge Magistrate ORDER FOR CHANGE OF NAME (ADULT) American LegalNet, Inc. www.USCourtForms.com