PROBATE COURT OF BUTLER COUNTY, OHIOIN RE: CHANGE OF NAME OF(Present Name) To(Name Requested) Case No.APPLICATION FOR CHANGE OF NAME OF ADULT [R.C. 2717.01]The applicant states that the applicant is an adult and has been a bona fide resident ofCounty, Ohio, for at least one year immediately prior to the filing of this application. The applicant requests a change of name from tofor the following reason:The applicant states that the applicant will cause notice of the application to be published once in a newspaper of general circulation in this county at least thirty (30) days before the hearing on this application.Attorney for ApplicantApplicant's SignatureTyped or Printed NameTyped or Printed NameAddressAddressCityZipStateCityZipStateTelephone Number (include area code)Telephone Number (include area code)Attorney Registration No.11/01/00FORM 21.0 -APPLICATION FOR CHANGE OF NAME OF ADULT2001 © American LegalNet, Inc.JUDGMENT ENTRY SETTING HEARING AND ORDERING NOTICEThe Court orders this application set for hearing on theday of,, ato'clock.m. The applicant is ordered to cause notice of the application to begiven by one publication in a newspaper of general circulation in this county at least thirty (30) days prior to the hearing date as required by law.Probate JudgeBy:Deputy Clerk2001 © American LegalNet, Inc.
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