SUPERIOR COURT OF THE DISTRICT OF COLUMBIA WASHINGTON, DC 20001 NOTICE TO CREDITORS Case No. __________________ This _____ day of _____________________ 20_____ In re: _______________________________________________________ APPLICANT’S FULL NAME TO: _____________________________________________________ NAME OF CREDITOR _________________________________________________________________ ADDRESS OF CREDITOR _________________________________________________________________ Pursuant to Superior Court Rules 205(b) you are hereby notified that the aboveͲcaptioned Application for Change of Name has been filed with the Court, and a copy of the application is attached hereto. The Court has set the time of final hearing as ______________________________. The final hearing will be held in JudgeͲInͲChambers, Room 4220 DC 20001 and/or Courtroom _________ in the District of Columbia at 500 Indiana Avenue NW, Washington, DC 20001. If you desire to oppose this application, you or your attorney must be present at the time and place or you must file three (3) days in advance thereof with the Clerk of the Court (Civil Division and/or Family Court) at the address appearing on this notice, an affidavit of your objections and the factual basis therefore. _________________________________________ ________________________________ Attorney’s signature and Bar Number Signature of the Applicant __________________________________________________ Address __________________________________________________ __________________________________________________ Telephone Number _______________________________________ Address _______________________________________ _______________________________________ Telephone Number Revised January 2011 American LegalNet, Inc. www.FormsWorkFlow.com