1 2 3 4 IN THE CIRCUIT COURT OF THE STATE OF OREGON 5 FOR THE THIRD JUDICIAL DISTRICT 6 7 In the Matter of the Change of Name of: ) ) 8 __________________________________________ ) ) 9 __________________________________________ ) Case No: __________ (Present Name(s) of Minor Child/ren) ) 10 ) NOTICE OF __________________________________________ ) PETITION FOR CHANGE11 ) OF NAME __________________________________________ ) 12 (Proposed Name(s) of Minor Child/ren) ) ) 13 __________________________________________ ) (Petitioner/Guardian Ad Litem) ) 14 TO ALL INTERESTED PERSONS: 15 This notice is to advise all persons that I have filed a petition to change16 ______________________________________________________ s name to 17 ______________________________________________________. If you object to this petition,18 you must file written objections showing cause why the petition for change of name should not19 be granted. Your objections must be filed by ________________. Your objections must be filed20 with the Marion County Circuit Court (mailing address: P.O. Box 12869, Salem, OR 97309-21 0869). 22 Dated____________ _______________________________23 Petitioner/Guardian Ad Litem 24 DO NOT REMOVE THIS NOTICE BEFORE _________________________________ 25 26 27 28 NOTICE OF PETITION FOR CHANGE OF NAME - Page 1 of 2 FC(3/1/04)(Form 3M)>>>> 2 1 Submitted by: 2 ______________________________________ 3 Attorney/Petitioners Name Bar No. (if any) 4 _____________________________________ Address 5 ______________________________________ 6 City State Zip Phone No. 7 ______________________________________ Trial Attorney if other than above Bar No. 8 9 Certificate of Document Preparation10 If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all boxes and complete all blanks that apply)11 A. G I selected this document for myself, and I completed it without paid assistance. B. G I paid or will pay money to _________________ for assistance in preparing this12 form/document 13 __________________________ Signature14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 NOTICE OF PETITION FOR CHANGE OF NAME - Page 2 of 2 FC(3/1/04)(Form 3M)