IN THE IOWA DISTRICT COURT FOR ____________ COUNTY IN RE THE NAME CHANGE OF: CASE NO: NOTICE, ACCEPTANCE OF SERVICE OF PETITION FOR NAME CHANGE BY SPOUSE AND CONSENT STATE OF IOWA COUNTY OF ___________ I, _____________________________________, am the spouse of the petitioner. I hereby acknowledge and receipt of and acceptance of this Notice of Service and the Petition for Change of Name filed by my spouse, _________________________________________ and consent to entry of an Order by the Court for changing my spouse's name from ____________________________________ to ______________________________________. I further waive any notice of hearing in this matter. Dated this _____ day of _______________, 20____. ______________________________________________ Spouse's Signature /s/____________________________________________ Printed name ______________________________________________ Mailing address City State Zip ______________________________________________ Phone number Email address Subscribed and sworn to by __________________________, before me a notary public, this ____ day of _____________________, 20___. _______________________________________________ Notary Public in and for the State of Iowa American LegalNet, Inc. www.FormsWorkFlow.com