SUPERIOR COURT OF FULTON COUNTY STATE OF GEORGIA FAMILY DIVISION , v. Petitioner, , Respondent. VERIFICATION I, ___________________________, personally appeared before the undersigned notary public and, being duly sworn, state that the facts stated in the foregoing Petition are true and correct. This ___ day of ______________________, ______(year) ______________________________ Signature Civil Action Case Number Name: Email: __________________________________ IF YOU DO NOT HAVE AN EMAIL ADDRESS, FILL OUT A CERTIFICATE OF NO EMAIL ADDRESS Telephone No.: ________________________________ Sworn to before me this ___ day of _____________, 20__. ___________________________ Notary Public Petition to Change Name of Adult -- Rev. Oct. 2015 Provided by the Fulton Family Law Information Center American LegalNet, Inc. www.FormsWorkFlow.com