IN THE CIRCUIT COURT FOR THE TWENTY- THIRD JUCICIAL CIRCUIT KENDALL COUNTY, ILLINOIS IN THE MATTER OF THE PETITION OF: GENERAL NO. FOR CHANGE OF NAME (MINOR) TO THE HONORABLE JUDGE OF THE CIRCUIT COURT: The petitioner (s) states that (he/she/they) currently reside(s) in Kendall County and (has/have) been a resident(s) of the State of Illinois for (length of time); that (he/she/they) (has/have) maintained residency in the State of Illinois for six months prior to filing of this petition, that (he/she/they) desire (s) a change of name according to the statute. The petitioner (s) place of birth and (his/her/their) date of birth; (county-state and date of birth) is; The petitioner (s) will give notice of (his/her/their) intended application by publication of three successive weeks beginning at least six weeks before the scheduled court date, in a newspaper of general circulation, published in Kendall County. WHEREFORE, your petitioner (s) pray (s) that (his/her/their) name be changed from (its/their) present form to as provided by statute, and that (he/she/they) have such other or further relief as this Honorable Court may order. Name: Attorney/Petitioner Attorney Registration No. Address City/State/Zip Telephone Date: Petitioner (s) _______ AFFIDAVIT being duly sworn on oath deposes and says that (he/she/they) (is/are) acquainted with the petitioner (s) in this cause, who (has/have) signed this petition; that (he/she) has read this petition, and knows the contents thereof, and that the same, and the matters and things therein state are true. Sworn and subscribed to before me: Date Affiant Clerk of Court-Notary Public American LegalNet, Inc. www.FormsWorkFlow.com