IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF WASHINGTON In the Matter of the Name Change of ____________________________________ (Minor's Present Legal Name ­ First Middle Last) Case No. ______________ CONSENT TO CHANGE OF NAME (Minor) (Form 6) to ____________________________________ (Minor's New Name ­ First Middle Last) less than I, __________________________, am _____ years old. I am aware that (Minor's present legal name) ______________________________ has petitioned this Court to be appointed as my (Guardian Ad Litem's name) Guardian Ad Litem and petitioned this Court to change my name. I waive further notice of this proceeding and consent to the appointment of Guardian Ad Litem and to the proposed change of name. Dated: _____________________ _______________________________ Signature of Minor Page 1- CONSENT TO CHANGE OF NAME (MINOR) American LegalNet, Inc. www.FormsWorkFlow.com