IN THE SUPERIOR COURT OF FULTON COUNTY STATE OF GEORGIA FAMILY DIVISION Civil Action File No: Petitioner: NOTICE OF PETITION TO CHANGE NAME Notice is hereby given that [1]_________________________________, the undersigned, filed his/her petition to the Superior Court of Fulton County, Georgia, on the [2]_____________________ day of [3]________________, _____, praying for change in the name of petitioner from [4]___________________ to [5]_____________________. Notice is hereby given pursuant to law to any interested or affected party to appear in said Court and to file objections to such name change. Objections must be filed with said Court within 30 days of the filing of said petition. This [6]____________________ day of [7]_____________________, _____. ____________________________________________ Signature Petitioner=s name (print or type): __________________ Petitioner=s address: ___________________________ ____________________________________________ Petitioner=s telephone number: ( ) Comment: The notice must be published in the Fulton County Daily Report once a week for four weeks. The time limit for filing objections can vary. See O.C.G.A. ' 19-12-1. If you cannot afford the filing and publishing fee, you may be able to have it waived if you file a poverty affidavit that is accepted by the court. See Form 1040. If you require materials in alternate format, please notify the Family Law Information Center as soon as possible. Notice of Petition to Change Name-rev. 9/99 8 1999 Fulton County Superior Court Family Division Page 1 of 1 2000 (C) American LegalNet, Inc.