This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois courts. NC - O 305.4 Page 1 of 1 (0 1 /1 9 ) STATE OF ILLINOIS, ORDER FOR NAME CHANGE (ADULT) For Court Use Only CIRCUIT COURT COUNTY Instructions Directly above, enter the county name where the case was filed . Request of: Enter your current name. Enter the case number given to you by the Circuit Clerk. Your current name (First, middle, last name) Case Number The Court reviewed your Request for Name Change and finds : DO NOT check any boxes on this form. The judge will check the correct boxes at the hearing. The Court has jurisdiction. Correct notice was done by newspaper publication. In this Newspaper: On these Dates: Notice requirement was waived. The statements made in the Request for Name Change meet the statutory requirements. The statements made in the Request for Name Change do not meet the statutory requirements. IT IS ORDERED : The Request for Name Change is GRANTED. The name of: Enter your current full name. First Middle Last is changed to: Enter the new full name you would like. First Middle Last The Request for Name Change is DENIED. The Request is denied for the following reasons: ENTERED: DO NOT enter the Judge and Date. The judge will sign here. Judge Date American LegalNet, Inc. www.FormsWorkFlow.com