PROBATE COURT OF WOOD COUNTY, OHIO David E. Woessner, Judge In the Matter of the CHANGE OF NAME OF:_______________________________________________ (Present Name) To________________________________________________________________________________ (Name Requested) Case No. ______________________________ JUDGMENT ENTRY - CHANGE OF NAME OF ADULT On ______________________________an Application for change of name was heard by this Court. The Court finds that proper notice of the Application and hearing date was given by one publication in a newspaper of general circulation in this county at least thirty days prior to the hearing on the Application. The Court further finds that reasonable and proper cause exists for changing the name. The Court finds that the Applicant's complete name at birth was _______________________________, Applicant's date of birth was ___________________________, and the place of birth was ___________ __________________________________________________________________________________ City County State Therefore, it is ORDERED the name of ___________________________________________________ be changed to_______________________________________________________________________ Date Journalized:_____________________ _________________________________ David E. Woessner, Probate Judge CERTIFICATION OF JUDGMENT ENTRY The above Judgment Entry - Change of Name of Adult is a true copy of the original kept by me as custodian of the records of this Court. By: _________________________________ Deputy Clerk _________________________________ Date FORM 800.AE -- JUDGMENT ENTRY - CHANGE OF NAME OF ADULT Crensch$\forms\800.AE.doc 800ae 11/27/00 American LegalNet, Inc. www.USCourtForms.com