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Consent To Change Of Name (Consent Of Parent Originally Listed On Birth Certificate) DR-64 - Maryland
| Consent To Change Of Name (Consent Of Parent Originally Listed On Birth Certificate) Form. This is a Maryland form and can be used in Name Change Domestic Relations (Pro-Se) Family Law Circuit Court Statewide . |
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: : Plaintiff(s) IN THE MATTER OF: Index No. Calendar No. : IN THE : JUDICIAL SUBPOENA -against- * * (child's current name) CIRCUIT COURT : FOR * FOR CHANGE OF NAME TO: * * : Defendant(s) : ...................................................... (child's new name) THE PEOPLE OF THE STATE OF NEW YORK (petitioner's name) BY AND THROUGH HIS/HER MOTHER/FATHER/GUARDIAN: * * * * * * Civil No.: TO * * * * * * * * * CONSENT TO CHANGE OF NAME (Consent of Person Originally Listed on Birth Certificate) GREETINGS: (DOM REL 64) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 1. Name, Age and Competence. , the Honorable at the Court . My date of birth is located at County ofMy name is inand I am capableon the room , of understanding what this consent means. 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 2. Status. I believe that I am NOT the father of (current name of child) , Your failure to comply with this subpoena is punishablelisted as the father on and will make you liable to born on , , although I am as a contempt of court his/her the party on whose(date of birth) subpoena was issued for a maximum penalty of $50 and all damages sustained as a behalf this result of your of Live Birth. Certificate failure to comply. Witness, , one of the Justices of the 3. Consent. Honorable Court in I hereby consent to having the child's name 20 County, day of , changed. I hereby join in the foregoing Petition and waive notice of process. I acknowledge that I have the right to revoke my consent at any time prior to when an order changing the child's name is entered. I acknowledge that I was provided the opportunity to consult with legal counsel, if (Attorney mustbefore signing this Consent. I so chose, sign above and type name below) I SOLEMNLY AFFIRM under the penalties of perjury that the contents of the foregoing Consent are true to the best of my knowledge, information, and belief. Attorney(s) for (date) (your signature) (your name - PRINTED) Office (street address) and P.O. Address Telephone No.: No.: E-Mail Address: NOTE: Changing a child's name will not change an existing child support obligation. Mobile Tel. No.: (telephone number) Facsimile Page 1 of 1 American LegalNet, Inc. www.USCourtForms.com (city , state , zip code) DR 64 - Revised 13 Feb 2001
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