Identity Record Change (Minor) 226 Notice Page 1 of 1 (Dec 2017) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF Notice to Parents and Legal Guardians of Petition to Change Name of Minor Child Re: (name of child) Case #: Petitioner Name: A Petition has been filed to change the name of your child in the Circuit Court for the county named above. Contact a lawyer if you have questions or issues about this process. You can contact the Oregon State Bar Lawyer Referral Service at www.oregonstatebar.org or call 503.684.3763 (toll-free in Oregon at 800.452.7636). American LegalNet, Inc. www.FormsWorkFlow.com Identity Record Change (Minor) 226 Declaration of Notice Page 1 of 1 (Dec 2017) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF In the Matter of: Case No: DECLARATION OF NOTICE RE: NAME CHANGE FOR Minor Child (current name) MINOR CHILD I am the Petitioner in this case. I provided a Notice to Parents and Legal Guardians of Petition to Change Name of Minor Child to the following parents and legal guardians: (list full names and address or method of notice) Name: Address or method of notice: Date: Certificate of Document Preparation. Check all that apply: I chose this form for myself and completed it without paid help A legal help organization helped me choose or complete this form, but I did not pay money to anyone I paid (or will pay) for help choosing, completing, or reviewing this form Guide & File selected and completed this form and I did not pay anyone to review the completed form I hereby declare that the above statements are true to the best of my knowledge and belief. I understand they are made for use as evidence in court and I am subject to penalty for perjury. Date Signature of Petitioner Name (printed) Contact Address City, State, ZIP Contact Phone American LegalNet, Inc. www.FormsWorkFlow.com