Consent To Change Of Name (Consent Of Parent Guardian Or Custodian)
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Consent To Change Of Name (Consent Of Parent Guardian Or Custodian) Form. This is a Maryland form and can be use in Circuit Court Statewide.
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Tags: Consent To Change Of Name (Consent Of Parent Guardian Or Custodian), DR-63, Maryland Statewide, Circuit Court
:
:
-against-
Calendar No.
:
Plaintiff(s)
Index No.
JUDICIAL SUBPOENA
:
:
IN THE MATTER OF:
*
IN THE
*
CIRCUIT COURT
:
(child’s current name)
*
FOR
Defendant(s) *
:
. . . . . . . . .FOR .CHANGE .OF NAME. TO: . . . . . . . . . . . . . . . * . . . . . .
... ....... ....... ...
.
*
(child’s new name)
*
*
BY AND THROUGH HIS/HER
THE PEOPLE OF THE STATE OF NEW YORK
*
*
*
MOTHER/FATHER/GUARDIAN:
TO
Civil No.:
*
*
(petitioner’s name)
*
*
*
*
*
*
*
*
*
*
*
CONSENT TO CHANGE OF NAME
(Consent of Parent, Guardian or Custodian)
GREETINGS:
(DOM REL 63)
1. Name, Age and Competence.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
My name is located at
. My date of birth is
County of
in room and I am on the of understanding what this consent means. in the
, capable
day of
, 20
, at
o'clock
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
2. Status as Parent or Guardian.
I am [ ] the mother [ ] the father (or) [ ] the guardian of
Your failure to comply with this subpoena is punishable as a contempt of court and will name of child) liable to
(current make you
the party on whose behalf this subpoena was, issuedon a maximum penalty of $50 and all damages sustained as a
for
born
,
.
result of your failure to comply.
(date of birth)
3. Consent.
Witness, Honorable
, one of the Justices of the
I hereby consent that of minor child’s name be changed from
Court in
County,
day the
, 20
(current name of child)
to
. I hereby join in the foregoing
Petition and waive notice of process. I acknowledge that I have the right to revoke my consent at
(Attorney must sign above and type name below)
any time prior to the date an order changing the child’s name is entered. I acknowledge that I
was provided the opportunity to consult with legal counsel, if I so chose, before signing this
Consent.
Attorney(s) for
I SOLEMNLY AFFIRM under the penalties of perjury that the contents of the foregoing
Consent are true to the best of my knowledge, information, and belief.
(date)
Office
(your signature) and
P.O. Address
(your name - PRINTED)
(street address)
Telephone
No.:
Facsimile No.:
(city , state , zip code)
E-Mail Address:
(telephone number)
Mobile Tel. No.:
NOTE: Changing the name of a child will not change an existing child support obligation.
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DR 63 - Revised 13 Feb 2001
