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Attachment To Petition For Change Of Name NC-110 - California
| Attachment To Petition For Change Of Name Form. This is a California form and can be used in Name Change Judicial Council . |
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NC-110 PETITION OF (Name of petitioner or petitioners): FOR CHANGE OF NAME CASE NUMBER: NAME AND INFORMATION ABOUT THE PERSON WHOSE NAME IS TO BE CHANGED Attachment to Petition (form NC-100 or form NC-200) Attachment of (You must use a separate attachment for each person whose name is to be changed. If petitioner is a guardian of a minor, a supplemental attachment, Declaration of Guardian (form NC-110G), must also be completed and attached for each minor whose name is to be changed.) 6. (Continued) Petitioner applies for a decree to change the name of the following person: Self Other b. (1) Present name (specify): (2) Proposed name (specify): (3) Born on (date of birth): over 18 years of age and presently under 18 years of age (4) Born at (place of birth): (5) Sex (as stated on original birth certificate): Male Female (6) Current residence address (street, city, county, and zip code): c. Reason for name change (explain): d. Relationship of the petitioner to the person whose name will be changed: near relative (indicate relationship): (4) (1) self parent (5) (2) other (specify): guardian (3) e. If the person whose name will be changed is under 18 years of age, provide the names and addresses, if known, of the following persons: (address): (1) Father (name): (address): (2) Mother (name): (3) (Only if neither parent is living) Near relatives (names, relationships, and addresses): f. If the person whose name will be changed is 18 years of age or older, that person must sign the following declaration: DECLARATION I declare under penalty of perjury under the laws of the State of California that I am not jurisdiction of the California Department of Corrections (in state prison or on parole) and required to register as a sex offender under Penal Code section 290. Date: I am I am not under the I am (TYPE OR PRINT NAME OF PERSON WHOSE NAME IS TO BE CHANGED) (SIGNATURE OF PERSON WHOSE NAME IS TO BE CHANGED) (If petitioner is represented by an attorney, the attorney's signature follows): Date: (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY) (Each petitioner must sign this petition in the space provided below or, if additional pages are attached, at the end of the last attachment.) I declare under penalty of perjury under the laws of the State of California that the information in the foregoing petition is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) Date: (TYPE OR PRINT NAME) ADD ADDITIONAL SIGNATURE LINES FOR ADDITIONAL PETITIONERS Form Adopted for Mandatory Use Judicial Council of California NC-110 [Rev. January 1, 2003] (SIGNATURE OF PETITIONER) SIGNATURE OF PETITIONERS FOLLOWS LAST ATTACHMENT Code of Civil Procedure, § 1275 et seq. ATTACHMENT TO PETITION FOR CHANGE OF NAME 2003 © American LegalNet, Inc.
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