IN THE PARKE COUNTY
STATE OF INDIANA )
COUNTY OF PARKE )
CAUSE NO: 61C01-2011-MI-000357
In re: The Name Change of Jean Frances Holder
VERIFIED PETITION FOR NAME CHANGE
Comes now, Jean Frances Holder, the Petitioner, in the above-captioned cause of action, and in support of her Petition for Name Change, she states the following:
- That the Petitioner is an adult female, age 63, born September 5, 1957.
- That the Petitioner’s address is 7887 E. Oak Drive, Rockville, IN 47872-8064.
- And that given the maturity of the Petitioner, no notice is required by statute to any parties except, by way of publication in the local newspaper, that being the Parke County Sentinel. That the Petitioner requests that this matter be set out four weeks in order to allow for the statutory publication period to expire.
- That the current legal name of the Petitioner is Jean Frances Holder, and she wishes that her name be changed to Jean Frances Burlingame Holder.
- That the Petitioner has no felony convictions, is not incarcerated, and seeks to have her name changed for no unlawful or deceptive reason.
WHEREFORE, the Petitioner requests the Court to grant her Petition, and all other just remedies.
James H. Holder, Jr.
I affirm under penalty of perjury that the foregoing is true to the best of my knowledge and belief.
Jean Frances Holder
ORDER SETTING HEARING ON PETITION FOR NAME CHANGE
The Court having heard, read, and contemplated the Petition for Name Change, now sets this matter for Hearing on the 17 day of December, 2020 at 11:00 a.m.
ORDERED this 5 day of November 2020.
Sam A. Swaim
HONORABLE JUDGE OF THE PARKE COUNTY CIRCUIT COURT