This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois courts. NC - N 304.3 Page 1 of 1 (0 1 /1 8 ) STATE OF ILLINOIS , PUBLICATION NOTICE OF COURT DATE FOR REQUEST FOR NAME CHANGE (ADULT For Court Use Only CIRCUIT COURT COUNTY Instructions Directly above, enter the name of the county 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 re will be a court date on my R equest to change my name from: Enter your current full name. First Middle Last to the new name of: Enter the new full name you would like. . First Middle Last Get the court date and time from the Circuit Clerk when you file the Request for Name Change. Make sure the date is at least 8 weeks after the date you file this form with the Circuit C lerk . The court date will be held : on at a.m. p.m., Date Time at , Enter the address of the court and the court room number. Street Address City County in Courtroom # . If you are completing this form on a computer, sign your name by typing it. If you are completing it by hand, sign and print your name. Room Number /s/ For information on how to publish this Notice, see How to Change your Name (for an Adult). Your Signature Your Current Name American LegalNet, Inc. www.FormsWorkFlow.com