OFP801 State ENG Rev 7/15www.mncourts.gov/formsPage 1 of 1State Of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: Domestic AbuseIn the Matter of: Petitioner (first, middle, last) Respondent (first, middle, last)vs.Notice of Change of Address (Minn. Stat. 247 518B.01) I, , the above named Petitioner Respondent,changed my permanent place of residence from that of: Address Apt. # City State Zip Codeto: Address Apt. # City State Zip Code Dated: Signature Name: Address: City/State/Zip: Telephone: E-mail address:Notice of Change of Address You are hereby notified that Petitioner/Respondent in the above named action has changed address, as indicated above. If Petitioner changed residence, a copy of this notice shall be filed with the District Court. Upon Petitioner's request, Petitioner's address shall be confidential. A copy of this notice shall be mailed with a copy of the original order to the Police Department having jurisdiction over Petitioner's new residence. Dated: Court Administrator/Deputy American LegalNet, Inc. www.FormsWorkFlow.com