Page 1 of 2 Decree of Name Change, DC 6:9(3) DECREE OF NAME CHANGE Nebraska State Court Form DC 6:9(3) IN THE DISTRICT COURT OF (county where Petition filed) COUNTY, NEBRASKA IN RE NAME CHANGE OF, CASE NO. . (case number assigned by lerk of ourt) DECREE OF NAME CHANGE (your full name) This matter came on for hearing on () upon Petition for Change of Name by the petitioner . (your current full name) The petitioner appeared pro se. The petitioner adduced evidence, and the ourt, being fully advised in the premises finds as follows: I. This ourt has full and complete jurisdiction of the party hereto and the subject matter hereof. II. At the time of filing the Petition herein, the petitioner was a resident of County and has been a bona fide resident of (county where Petition filed) County for more than one year prior to the filing of the petition. (county where Petition filed) III. Petitioner wishes to change his her name of , to (check one) (your current full name) . (your new full name) American LegalNet, Inc. www.FormsWorkFlow.com Page2 of 2 Decree of Name Change, DC 6:9(3) IV. There exists proper and reasonable cause for changing the name of the petitioner. V. Petition for Name Change was published in the , (name of legal newspaper) pursuant to Neb. Rev. Stat. 247 25-21, 271 (2)(a). IT IS THEREFORE ORDERED, ADJUGED AND DECREED THAT: The petitioner222s name of name is changed (your current full name) to the name of . (your new full name) BY THE COURT: District Court Judge American LegalNet, Inc. www.FormsWorkFlow.com