COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... YAKIMA COUNTY DISTRICT COURT THE PEOPLE OF THE STATE OF NEW YORK NO.:_________________________________ In the Matter of the Change of Name of: TO _____________________________________, [Print legibly or type your full name here] Petitioner GREETINGS: PETITION FOR CHANGE OF NAME [ADULT] WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County ofI am Petitioning for a court order that will change my name from: 1. in room , on the day of , 20 , 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 to Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party Mywhosedate is:this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 2. on birth behalf result of your failure to comply. 3. My father’s name is : Witness, Honorable Court 4. My mother’s name is: in County, , one of the Justices of the day of , 20 5. I reside in Yakima County, Washington. (Attorney must sign above and type name below) 6. This application is made for the following reason(s): Attorney(s) for 7. I am not making this Petition for any illegal or fraudulent purposes or to defraud any creditors. The change of name would not be detrimental to the interest of any other person. Office and P.O. Address PETITION NAME CHANGE – ADULT 5/2004 Page 1 of 2 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : 8. Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA I am not subject to the jurisdiction of the Washington Department of Corrections. -against- : I am subject to the jurisdiction of the Washington State Department of Corrections. I : certify that I provided a copy of this Petition to the Department on . I know I must provide a copy of any order granting a name change to the Department : within five days of its entry by the Court and that failure to do so is a crime. Defendant(s) : . . . . . 9.. . . . .I. am .not. subject .to. the. sex .offender .registration.laws of the State of Washington. . ... .. ...... . .. ... ....... ......... . I am subject to the sex offender registration laws of the State of Washington. I certify that IOF THE STATE OF NEW YORK to the Yakima County Department on THE PEOPLE provided a copy of this Petition and the Washington State Patrol on . I know I must provide a copy of any order granting a name change to the sheriff of the County where I reside and to the TO Washington State Patrol within five days of its entry by the Court and that failure to do so is a crime. GREETINGS: 10. I declare under penalty of perjury under the laws of the State of Washington that the foregoing statements are true and correct. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room day of , 20 , at o'clock in the noon, and at any recessed Signed at , on the on or adjourned date, to testify and give evidence as a witness in this action on the part of the [Write in city where you signed this form] [Write in date you signed this form] Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to 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. [Sign your name here] Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address PETITION NAME CHANGE – ADULT 5/2004 Page 2 of 2 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com