VERIFIED PETITION FOR CHANGE OF NAME CAUSE NO. 20D03-1609-MI-00272 IN THE ELKHART COUNTY SUPERIOR COURT FOR THE STATE OF INDIANA, COUNTY OF ELKHART, SS: IN RE THE NAME CHANGE OF: JOHNNY MICHAEL BROWN, Petitioner. Petitioner, Johnny Michael Brown , by counsel, respectfully petitions this court to change his name. In support of this Petition, Petitioner states as follows: 1.That my current name is: Johnny Michael Brown. 2.That I am 63 years of age, my date of birth is: 08/03/52. 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: 123 N. Clinton St., Millersburg, Indiana. 5.The following is a list of all of my previous names: None 6.That I don't hold a valid Untied States passport. My proof that I am a United States citizen is Certified birth certificate. I will bring this document to my Change of Name Hearing for verification. 7.That 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 name change 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 I.C. 11-8-8. 11.That pursuant to Indiana Code 34-28-2-1, I wish to change my name. 12.That I wish to change my name to: Johnny Michael Kimberlin. WHEREFORE, I respectfully request that this Court grant my Petition for Name Change, and for all other just and proper relief. I affirm under the penalties of perjury that the foregoing representations are true. Johnny Michael Brown Respectfully submitted, Galen K. Kauffmann, 14276-20 McLaughlin, Simpson, Edberhard & Kauffmann, P.C. 120 N. 5th St. Goshen, IN 46528 (574) 533-3580 September 26 October 3, 10 hspaxlp
↧