VERIIFED PETITION FOR CHANGE OF NAME OF MINOR CASE NO. 20C01-1607-Mi-208 IN THE ELKHART CIRCUIT COURT FOR THE STATE OF INDIANA, COUNTY OF ELKHART, SS: IN RE CHANGE OF NAME OF MINOR: Arabella Dawn Arterburn Petitioner, April Dawn Keene Petitioner, April Dawn Keene, pro se, respectfully petitions this Court to Change the Name of the above-noted child. In support of this Petition, Petitioner states as follows: 1.Petitioner is the mother/guardian 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 is not required under I.C. 31-19-9. 3.That the child's current name is: Arabella Dawn Arterburn 4.The following is a list of all of the previous names of the child: Arabella Dawn Arterburn 5.That I will bring the child's identification card to the Change of Name Hearing for verification. 6.That the child does not hold a valid United States passport. Proof the the child is a United States citizen is Birth Certificate. I will bring this document to the Change of Name Hearing for verification. 7.That the following judgments of criminal convictions of a felony under the laws 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. 8.That changing the child's name is not an effort to defraud any of the child's creditors. 9.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. 10.That the child is not confined to a Department of Correction facility or a sex or violent offender who is required to register under I.C. 11-8-8. 11.That pursuant to Indiana code 34-28-2-1, I petition this Court to change the child's name. Pursuant to Indiana Code 34-28-2-2 (b), the reason the change of the child's name is requested is: Her biological father has not been involved in her life since she was one year old; and her stepfather that she calls "Dad" has been raising her since she was one year old. 12.That I request that the child's name be changed to: Arabella Dawn Keene 13.I request this Court to set a hearing to consider the Petition for Change of Name of Minor Child. WHEREFORE, I respectfully request that this Court grant this Petition for Name Change of a Minor, and for all other just and proper relief. I affirm under the penalties of perjury that the foregoing representations are true. April D. Keene, Petitioner 812 B Highland Drive, Goshen, IN 46528 July 25 August 1, 8 hspaxlp
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