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 TO In the Matter of the Change of Name of: NO. ______________________________ _______________________________________, GREETINGS: [Legibly print or type the minor’s full name here] Petitioner PETITION FOR CHANGE OF NAME WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before [MINOR] , theBy: ____________________________________, the Honorable at Court located Guardian at County of Parent/Legal 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 1. I am petitioning for a court order that will change the name of my child or ward name from: 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 to your failure to comply. of Witness, Honorable 2. My minor’s birth date is: Court in County, day of 3. My minor’s father’s name is : , one of the Justices of the , 20 4. My minor’s mother’s name is: (Attorney must sign above and type name below) 5. I reside in Yakima County, Washington. 6. This application is made for the following reason(s): Attorney(s) for 7. This Petition is not made for any illegal or fraudulent purposes or to defraud any creditors. The Office and P.O. Address change of name would not be detrimental to the interest of any other person. PETITION NAME CHANGE – MINOR 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : 8. Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) The minor is not subject to the jurisdiction of the Washington Department of Corrections. -against: The minor is 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. The minor is not subject to the sex offender registration laws of the State of Washington. : ...................................................... The minor is subject to the sex offender registration laws of the State of Washington. I certify that I provided a copy of this Petition to the Yakima County Department on and the Washington State Patrol onNEW YORK . I know I must provide a copy of any order THE PEOPLE OF THE STATE OF granting a name change to the sheriff of the County where I reside and to the Washington State Patrol within five days of its entry by the Court and that failure to do so is a crime. TO 10. The undersigned declares under penalty of perjury under the laws of the State of Washington that the foregoing statements are true and correct. GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Signed at on , the Honorable at the Court [Write in city where you signed this form] [Write in date you signed this form] located at County of 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 [Signature of Parent or Legal Guardian] 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. Signed at on [Write in Honorable you signed this form] [Write in date you the Justices form] Witness, city where , one of signed this of the Court in County, day of , 20 [Signature of Second Parent or Legal Guardian] (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address PETITION NAME CHANGE – MINOR 5/2004 Page 2 of 2 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com