COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF STARK COUNTY, OHIOCalendar No.IN RE: CHANGE OF NAME OF(Present Name) ToJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)(Name Requested) Case No.JUDGMENT ENTRY -CHANGE OF NAME OF ADULT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Onan application for change of name was heard by this Court. The Courtfinds that proper notice of the application and hearing date was given by one publication in a newspaper of generalTHE PEOPLE OF THE STATE OF NEW YORK TOcirculation in this county a t least thirty days prior to the hearing on the application. The Court further finds thatreasonable and proper cause exists for changing the name.The Court finds that the applicant's complete name at birth wasGREETINGS:applicant's date of birth was, and the place of birth wasWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,CityCountyStatelocated at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomTherefore, it is ORDERED the name ofbe changed t oYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Robert D. Horowitz -Probate Judge, one of the Justices of theCourt in Witness, Honorableday of, 20 County,CERTIFICATION OF JUDGMENT ENTRY(Attorney must sign above and type name below)The above Judgment Entry -Change of Name of Adult is a true copy of the original kept by me as custodianAttorney(s) forof the records of this Court.Probate Judge/ClerkOffice and P.O. AddressByDeputy ClerkTelephone No.: Facsimile No.: E-Mail Address:DateMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comFORM 21.1 -JUDGMENT ENTRY -CHANGE OF NAME OF ADULT11/01/00