Sworn Statement Of True Name And Pseudonym
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Sworn Statement Of True Name And Pseudonym Form. This is a Florida form and can be use in Juvenile Statewide.
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Tags: Sworn Statement Of True Name And Pseudonym, 8.988, Florida Statewide, Juvenile
IN THE COUNTY COURT
IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT
IN AND FOR ___________________ COUNTY, FLORIDA
______________________ DIVISION
,
Petitioner,
-vs,
Respondent(s).
)
)
)
)
)
)
)
)
Case No.
Judge
SWORN STATEMENT OF TRUE NAME AND PSEUDONYM
NOTICE TO THE CLERK OF COURT: A CERTIFIED COPY OF THIS DECLARATION WITH THE CASE
NUMBER NOTED ON IT SHALL BE GIVEN TO THE MINOR AFTER SHE SIGNS IT. THE ORIGINAL
SHALL IMMEDIATELY BE PLACED IN A SEALED ENVELOPE WHICH SHALL BE FILED UNDER SEAL
AND KEPT UNDER SEAL AT ALL TIMES.
(1) My true name is
, and my address is
(2) My date of birth is
.
(3) I have filed a Petition for Judicial Waiver of Parental Notice of Termination of Pregnancy under the name or
initials on
, 20
.
I understand that by signing this form I am swearing to or affirming the truthfulness of the information herein and
that the punishment for knowingly making a false statement includes fines, imprisonment or both.
Dated:
Signature: __________________________________
(You must sign your true name.)
Sworn Statement Of True Name And Pseudonym (8.988}
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