VERIFIED PETITION FOR CHANGE OF NAME OF MNOR CAUSE NO. 20D02-1908-MI-326 IN THE ELKHART SUPERIOR 2 COURT FOR THE STATE OF INDIANA, COUNTY OF ELKHART, SS: IN RE THE NAME CHANGE OF MINOR: Kylan Shayne Clements Marlena Rae Clements, Petitioner Petitioner, Marlena Rae Clements, self-represented, respectfully petitions the Court to change the name of the above-noted child. In support of this Petition, Petitioner states as follows: 1.Petitioner is the parent of the child whose name is sought to be changed. 2.The written consent of the non-petitioning parent or guardian for the name change of the minor child is filed with this Petition. 3.That the child's current name is Kylan Shayne Clements. 4.That I will bring the child's identification information to my Change of Name Hearing for verification. 5.That the child does not hold a valid United States passport. Proof that the child is a United States citizen is Birth Certificate. I will bring this document to the Change of Name Hearing for verification. 6.That the following judgments of criminal conviction of a felony under the law of any state or the United States have been entered against the child, or I have stated immediately below that the child does not have any felony convictions: The child does not have any felony convictions. 7.That changing the child's name is not an effort to defraud any of the child's creditors. 8.That notice of the request for name change has been published in a local publication as required by law and will be brought to the Change of Name Hearing. 9.That the child is not confined to a Department of Correction facility or a sex or violent offender who is required to register under Indiana code 11-8-8. 10.That pursuant to Indiana Code 34-28-2-1, I petition this Court to change the child's name. 11.That I request that the child's name be changed to Kylan Lee Linville. 12.That I request that the name on the child's birth certificate be changed to their new, changed name. Specifically, Kylan Lee Linville. 13.The non-petitioning parent or guardian of the minor child has been served with a copy of this Petition as required by the Indiana Trial Rules. WHEREFORE, I respectfully request that this Court grant this Petition for Name Change of Minor, and for all other just and proper relief. I affirm under penalties of perjury that the foregoing representations are true. Marlena Clements, Petitioner August 22, 29 September 5 hspaxlp
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