Rev. 5/16/18 STATE OF NEW MEXICO COUNTY OF BERNALILLO SECOND JUDICIAL DISTRICT COURT No. IN THE MATTER OF THE PETITION OF 001001001001001001001001001001001001001001001001001001001001001001001001001001001001001001001001001001001 FOR CHANGE OF NAME OF MOTHER'S CONSENT TO NAME CHANGE states that she is the natural mother of minor (mother's name) ; she consents to the name change of said minor (child222s current name) to . (child222s new name) DATED this day of , 20 Mother's Signature Mother's Name Printed Street Address City, State, Zip Code American LegalNet, Inc. www.FormsWorkFlow.com Rev. 5/16/18 STATE OF NEW MEXICO ) ) ss. COUNTY OF ) I, , being first duly sworn upon my oath, depose and state that I am the mother in the above-entitled cause. I have read the attached MOTHER'S CONSENT TO NAME CHANGE of my minor child. I state that the contents thereof are true and correct, except to the matters stated on information and belief, and those matters I believe to be true. Signature: Mother Print Name: SUBSCRIBED AND SWORN TO before me this day of , 20, by . Notary Public My Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com