PROBATE COURT OF MONTGOMERY COUNTY, OHIO ALICE O. MCCOLLUM, JUDGE IN RE: CHANGE OF NAME OF ________________________________ (Present Name) TO __________________________________________________________ (Name Requested) CASE NO. ___________________________________________________ MAGISTRATE'S DECISION CHANGE OF NAME Pursuant to prior order filed in Case No. 2003 MSC 342545, directing a reference to me to hear and determine according to law, matters pertaining to name changes, I proceeded to hear and examine all of the evidence in the captioned matter. On __________________________ an application for change of name was heard by the undersigned. I find that proper notice of the application and hearing date was given by one publication in a newspaper of general circulation in the county at least thirty days prior to the hearing. I further find that reasonable and proper cause exists for changing the name. I find the applicant's complete name at birth is _________________________ ____________________________________________________, the applicant's date of birth is __________________________________________ and the place of birth is _______________________________________________________________________. (City) (County) (State) Therefore, it is my RECOMMENDATION that the name of _________________ ___________________________________________________________ be changed to _______________________________________________________________________ . The applicant has waived the fourteen day objection period to this decision under Civil Rule 53. ______________________________ Magistrate M.C. Form 21.1.1 ­ Magistrate's Decision ­ Change of Name 02/25/2011 American LegalNet, Inc. www.FormsWorkFlow.com