VERIFIED PETITION FOR CHANGE OF NAME CAUSE NO. 20C01-1908-MI-327 IN THE ELKHART CIRCUIT COURT FOR THE STATE OF INDIANA, COUNTY OF ELKHART, SS: IN RE THE NAME CHANGE OF: Bobbie Eugene Hurst, PETITIONER Petitioner, Bobbie Eugene Hurst, pro se, respectfully petitions the Court to change his name. In support of this Petition, Petitioner states as follows: 1.That my current name is Bobbie Eugene Hurst 2.That my date of birth is April 10, 1942 3.That I will bring my Indiana driver's license or identification card to my Change of Name Hearing for verification. 4.That my mailing address is 21023 River Blvd., Goshen, IN 46528. 5.The following is a list of all of my previous names: Bobbie Eugene Hurst 6.That I do not hold a valid United States passport. My proof that I am a United States citizen is birth certificate. I will bring this document to my Change of Name Hearing for verification. 7.The following judgments of criminal conviction of a felony under the law of any state or the United States have been entered against me, or I have stated immediately below that I have no felony convictions: I have no felony convictions 8.That I am not seeking to defraud creditors by changing my name. 9.That I have published notice of my request for Change of Name in a local publication as required by law, and will bring proof of publication to the hearing. 10.That I am not a sex or violent offender who is required to register under Indiana Code 11-8-8. 11.That I wish to change my name to Bobby Gene Hurst. 12.That I request that the name on my birth certificate be changed to my new, changed name. Specifically, Bobby Gene Hurst WHEREFORE, I respectfully request that this Court grant my Petition for Name Change, and for all other just and proper relief. I affirm under penalties for perjury that the foregoing representations are true. Bobbie Eugene Hurst August 24, 31 September 7 hspaxlp
↧