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Petition To Change Name Of Minor Form. This is a Vermont form and can be use in Probate Court Statewide.
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Tags: Petition To Change Name Of Minor, 123, Vermont Statewide, Probate Court
COURT
Probate Court Form
COUNTY .OF .No.. 123 . . . .
. .Petition .to. Change.Name .of Minor
.... . .. . .
................................
:
Index No.
STATE OF VERMONT
PROBATE COURT
:
DISTRICT OF _______________________
Calendar No.
:DOCKET NUMBER ______________
IN RE
JUDICIAL SUBPOENA
Plaintiff(s)
_____________________________
-against:
PETITION TO CHANGE NAME OF MINOR
:
Part I. Request for Change of Name
:
The undersigned petitioner represents as follows:
Defendant(s)
:
......................................................
That the minor’s name is : ___________________________________
That the minor was born at __________________________ on ___________________________
THE PEOPLE OF THE STATE OF NEW YORK State
Town/City and
Date of Birth
That the parents of the minor are:
TO
Name: _______________________
Name: _______________________
Address: _____________________
Address: _____________________
_____________________________
_____________________________
GREETINGS:
_____________________________
_____________________________
WE COMMAND YOU, that the business and excusesby _________________________________ before
That the guardian, if any, for all child was appointed being laid aside, you and each of you attend
,
the Honorable
at the
Court
and has the following name and address :
Name of Court
located at
County of
in room Name: _________________________ , 20
, on the
day of
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Address: _______________________
_______________________________
_______________________________
Your the name Icomply with thisto be known as is ______________________________________ liable to
That failure to wish the minor subpoena is punishable as a contempt of court and will make you
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.
That the reason for changing the minor’s name is as follows:
_____________________________________________________________________________________
Witness, Honorable
, one of the Justices of the
Court in Dated _________________________
County,
day of
, 20
__________________________________
Petitioner
At ________________________ on this ______ day of __________________, 20____,
_________________________ personally appeared before me and acknowledged this instrument, by him/her
(Attorney must sign above and type name below)
subscribed, to be his/her free act and deed.
____________________________________
Judge/Register
Attorney(s) for
Part II. Consent
I, _______________________________, whose relationship with the minor is that of
____________________________, consent to the change of name of the minor from
_____________________________________ to the new nameOffice and P.O. Address
of ________________________________.
Dated at ________________ this ____________ day of _________________________, 20____.
Signed _____________________________
Telephone No.:
Print Name _________________________
Facsimile No.:
Address ____________________________
E-Mail Address:
___________________________________
Mobile Tel. No.:
Telephone (___)______________________
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