Free Affidavit of Service by Registered Mail - Arizona

NAME CHANGE FOR AN ADULT

PINAL COUNTY
TO MAKE A REQUEST FOR A CHANGE OF NAME FOR AN ADULT WHO HAS NO MINOR CHILDREN INSTRUCTIONS AND FORMS
Provided as a Public Service By Kristi Youtsey Ruiz Clerk of the Superior Court

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version

PINAL COUNTY CLERK OF SUPERIOR COURT SELF SERVICE CENTER

APPLICATION FOR CHANGE OF NAME OF AN ADULT WITH NO MINOR CHILDREN
CHECKLIST
USE THE FORMS AND INSTRUCTIONS in this packet only if the following factors apply to your situation:
You want to ask the court to change your name, AND You are an adult 18 years or older,

AND You do not have any minor children.

NOTE: For information regarding name changes that can be obtained without going to court, or to add a name to, or change a name on a birth certificate, please contact the Arizona Department of Health Services, Bureau of Vital Records at (602) 364-1237.

READ ME: It is very important for you to know that when you sign a court document, you
may be helping or hurting your court case. Before you sign any court document, or get involved with a court case, it is important that you see a lawyer to make sure you are doing the right thing.

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version

PINAL COUNTY CLERK OF SUPERIOR COURT SELF SERVICE CENTER PROCEDURES: HOW TO FILE FOR A CHANGE OF NAME WITH THIS COURT FOR AN ADULT WITH NO MINOR CHILDREN STEP 1:
FILL OUT THE FORMS: Use Black Ink Only. Keep Forms Neat & Clean. Do Not Fold Forms. Do Not Use Line Paper When Including Attachments. Fill out the "Application for Change of Name for an Adult", "Civil Cover Sheet" and the "Notice of Hearing Regarding Application for Change of Name" (leave date, time and location blank).

STEP 2: STEP 3:

MAKE COPIES: Make 2 copies of the "Application for Change of Name for an Adult" FILE THE PAPERS AT THE COURT: WHO: Who must file the "Application for Name Change of an Adult"? The adult, 18 years or older, seeking the name change, or their attorney, must file the papers. GO TO: GO TO THE CLERK OF COURT TO FILE YOUR PAPERS: The Court is open from 8am-5pm, Monday-Friday. You should go to the Court at least two hours before it closes. You may file your court papers at the following Superior Court locations: Clerk of Superior Court 820 E. Cottonwood Ln Bldg B Casa Grande, AZ 85122 (520) 836-1073 Clerk of Superior Court 575 N. Idaho Road Ste 109 Apache Junction, AZ 85119 (480) 982-4166

FLORENCE: Clerk of Superior Court CASA GRANDE: 971 Jason Lopez Circle Bldg A Florence, AZ 85132 (520) 866-5300 MAMMOTH: Clerk of Superior Court APACHE JUNCTION: 118 Catalina County Complex Mammoth, AZ 85618 (520) 487-2928 FEES:

Please check with the Clerk's office for the current filing fee. The fee is payable to the Clerk of the Superior Court by cash, money order, visa or mastercard or personal check with proper identification. If the filing fee is a hardship and you think a fee deferral is appropriate, ask the staff at the Customer Service Counter for an Application for Fee Deferral before you file your Petition. Note: With the Application for Deferral, you must provide proof of income (copy of your last 2 most recent paystubs)

PAPERS: Give your original application and all copies to the Clerk along with the filing fee. Make sure the filing clerk conforms (stamps) all of your copies and returns them to you.

STEP 4:

SCHEDULE YOUR HEARING AT THE TIME OF FILING: After filing the application, the clerk will complete the "Notice of Hearing Regarding Application for Change of Name" to show the date (depending on your method of service), time, and place of your hearing. You must request copies of this form.

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version

STEP 5:

NOTIFY ANY INTERESTED PARTY: WHO: You must notify your spouse, if you are married, about your request for name change and the scheduled hearing. HOW TO NOTIFY: If you know where your spouse lives, you can do one of the following: 1. IF YOUR SPOUSE AGREES WITH YOUR REQUEST ­ Give your spouse a stamped copy of your application and the "Notice of Hearing Regarding Application for Change of Name" that shows the date, time, and place of your hearing. Then, have your spouse complete the form entitled, "Consent of Spouse to Name Change of an Adult and Waiver of Notice" and have it notarized. That document serves as your proof of notice. Bring the signed and notarized "Consent of Spouse to Name Change of an Adult and Waiver of Notice" to the hearing. 2. IF YOUR SPOUSE DOES NOT AGREE WITH YOUR REQUEST OR YOU ARE NOT SURE IF HE/SHE AGREES - Give your spouse a stamped copy of your application and the "Notice of Hearing Regarding Application for Change of Name" that shows the date, time, and place of your hearing. Then, have the person sign an "Acceptance of Service". That notarized form serves as the proof of notice. Bring the signed and notarized "Acceptance of Service" to the hearing; OR, 3. Send a copy of your application bearing the Clerk's stamp and the "Notice of Hearing Regarding Application for Change of Name" showing the date, time, and place of hearing by certified mail/restricted delivery (return receipt requested). This must be done at least 30 days before the hearing. Proof of notice for this step is the card returned to you from the Post Office showing delivery. Bring the card and a completed "Affidavit of Service by Certified Mail" to the hearing. The person who should receive notice of the hearing must sign the return receipt. If you do NOT know where your spouse lives: A Notice of Hearing that shows the date, time, and place of your hearing must be published once in a newspaper of general circulation in Pinal County at least 14 days before the hearing. This is called notice by publication. If notice is by publication, you must complete a notarized statement explaining in detail what efforts you made to locate the person(s). Bring that statement with you to the hearing. The Court will not accept notification by publication unless diligent efforts have been made to locate the person for whom notification is required.

STEP 6:

ATTEND THE HEARING: WHO: All adults who are requesting a name change MUST be present at the hearing. BRING: These documents are required for your hearing: · 2 copies of "Order Changing Name for an Adult" · Photo identification for any person(s) who requests the change of name · Proof of Notice as described above in Step 5 · Divorce Decree (If applicable) · Prior Name Change orders (If applicable) · Proof of naturalization or resident alien status (If applicable) · Copy of Orders of Protection and/or Injunctions Against Harassment still in effect (If applicable) · If the person requesting the change of name is not a United States citizen, his/her passport or proof of immigration status must also be provided at time of hearing.

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version

AFTER THE HEARING: If the Judge grants the name change(s), the Order Changing Name will be signed and you will be directed the to Customer Service Counter to receive a conformed copy of the Order. You may need to purchase a certified copy of the Order to complete the change of name with other state and local government agencies. Please check with the Clerk's office for the current fee for purchasing a "Certified Copy" of the Order Changing Name. The fee is payable to the Clerk of the Superior Court by cash, money order, visa or mastercard

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

IN THE SUPERIOR COURT OF ARIZONA PINAL COUNTY
CV
In the Matter of:
) ) ) )

2

APPLICATION FOR CHANGE OF NAME FOR AN ADULT [351]

Name of Applicant

STATEMENTS TO THE COURT, UNDER OATH
1. INFORMATION ABOUT ME, THE APPLICANT Name: Address: Date of Birth: County of Residence: Place of Birth: I ask that my name be changed to:

2.

3.

REASON FOR THIS REQUEST FOR CHANGE OF NAME , be changed to I request that the current name of for the following reason(s):

,

4.

ADDITIONAL STATEMENTS Yes No A. Has the applicant listed above been convicted of a felony? B. This application is made solely for the best interest of the person named above. It will not release the person from any obligations incurred or harm any rights of property or action in any original name. OATH AND VERIFICATION OF APPLICANT: ) ) ss.

STATE OF ARIZONA COUNTY OF PINAL

I, the Applicant, being duly sworn and under oath, state that I have read this Application. All the statements in the Application are true, correct, and complete to the best of my knowledge and belief. Applicant's Signature SUBSCRIBED AND SWORN TO before me this day of 20 .

By My Commission Expires: Deputy Clerk/Notary Public

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version

In the Superior Court of the State of Arizona In and For the County of PINAL Case Number CV 2
CIVIL COVER SHEET- NEW FILING ONLY

Is Interpreter Needed? If yes, what language:

Yes

No .

To the best of my knowledge, all information is true and correct.

(Please Type or Print) Plaintiff's Attorney ________________________ Attorney Bar Number_______________________ Plaintiff's Name(s): (List all) ______________________________________ ______________________________________ Plaintiff's Address: _______________________________________ _______________________________________
______________________________________________ Attorney / Pro Per Signature (If no attorney, YOUR Signature)

(List additional plaintiffs on page two and/or attach a separate sheet). Defendant's Name(s): (List All) ___________________________________________________ _____________________________________ ___________________________________________________

(List additional defendants on page two and/or attach a separate sheet)) Temporary Restraining Order Provisional Remedy EMERGENCY ORDER SOUGHT: OSC Election Challenge Employer Sanction Other ____________________________________________ (Specify) RULE 8(i) COMPLEX LITIGATION DOES NOT APPLY. (Mark appropriate box under Nature of Action) RULE 8(i) COMPLEX LITIGATION APPLIES. Rule 8(i) of the Rules of Civil Procedure defines a "Complex Case" as civil actions that require continuous judicial management. A typical case involves a large number of witnesses, a substantial amount of documentary evidence, and a large number of separately represented parties. (Mark appropriate box on page two as to complexity, in addition to the Nature of Action case category).
NATURE OF ACTION (Place an "X" next to the one case category that most accurately describes your primary case.) TORT MOTOR VEHICLE: C01 Non-Death/Personal Injury C02 Property Damage C03 Wrongful Death TORT NON-MOTOR VEHICLE: C13 Negligence C19 Product Liability - Asbestos C19 Product Liability ­ Tobacco C19 Product Liability ­ Toxic/Other C18 Intentional Tort C16 Property Damage MEDICAL MALPRACTICE: C21 Physician M.D. C23 Hospital C22 Physician D.O. C24 Other CONTRACTS: C31 Account (Open or Stated) C32 Promissory Note C33 Foreclosure C34 Buyer ­ Plaintiff C34 Fraud C34 Other Contract (i.e. Breach of Contract) C34 Excess Proceeds ­Sale C34 Construction Defect Resident/Commercial

C18 Legal Malpractice C18 Premises Liability
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

C34 six to Nineteen Structures
Name Change of Adult no Children Use most current version

C18 Slander/Libel/Defamation C18 Other (Specify)

C34 Twenty or More Structures

OTHER CIVIL CASE TYPES: C82 Eminent Domain / Condemnation C42 Forcible Detainer C43 Change of Name C44 Transcript of Judgment C45 Foreign Judgment C49 Quite Title C52 Forfeiture ­ Vehicle C53 Forfeiture - Cash C54 Forfeiture - Other C56 Election Challenge C58 NCC ­ Employer Sanction Action (ARS §23-212) C64 Injunction against Workplace Harassment C62 Injunction against Harassment C54 Civil Penalty C56 Water Rights (Not General Stream Adjudication) C56 Real Property C56 Sexually Violent Person (ARS §36-3704) C56 Minor Abortion Special Action Against Lower Courts C71 JP Civil Traffic C72 Municipal Civil Traffic C73 Civil Non-Traffic C74 Landlord - Tenant

UNCLASSIFIED CIVIL: C55 Administrative Review C60 Tax Appeal (All other tax matter must be filed in the AZ Tax Court) C46 Declaratory Judgment C48 Habeas Corpus C56 Landlord Tenant Dispute - Other C50 Restoration of Civil Rights (Federal) C56 Clearance of Records (ARS §13-4051) C56 Declaration of Factual Innocence C56 Declaration of Factual Improper Party C56 Vulnerable Adult (ARS §46-451) C56 Tribal Judgment C56 Structured Settlement (ARS § 12-2901) C56 Attorney Conservatorships (State Bar) C56 Unauthorized Practice of Law State Bar C56 Out-of-State Deposition Foreign Juris C56 Secure Attendance of Prisoner C56 Assurance of Discontinuance C56 In-State Deposition Foreign Jurisdiction C56 Eminent Domain ­ Light Rail Only C56 Interpleader ­ Automobile Only C56 Delayed Birth Certificate C56 Employment Dispute - Discrimination C56 Employment Dispute -Other C56 Other (Specify)

COMPLEXITY OF THE CASE If you marked the box on page one indicating that Complex Litigation applies, place an "X" in the box of no less than one of the following: Antitrust/Trade Regulation Construction Defect with many parties or structures Mass Tort Securities Litigation with many parties Environmental Toxic Tort with many parties Class Action Claims Insurance Coverage Claims arising from the above-listed case types A Complex Case as defined by Rule 8(i) ARCP Additional Plaintiff(s) __________________________________________________________________________________________ __________________________________________________________________________________________ Additional Defendant(s)
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED Name Change of Adult no Children Use most current version

__________________________________________________________________________________________ __________________________________________________________________________________________
Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

SUPERIOR COURT OF ARIZONA PINAL COUNTY
In the Matter of ) ) ) ) )

CV

2

CONSENT OF SPOUSE TO NAME CHANGE OF AN ADULT AND

WAIVER OF NOTICE

Name of Applicant

REQUIRED INFORMATION FROM SPOUSE, UNDER OATH:
1. INFORMATION ABOUT ME:
Name: Address: Telephone: Date of Birth: I am the spouse of the applicant.

2.

I have read the Application for Name Change and I consent to my spouse changing their name to:

3.

I waive notice of all further proceedings in this matter. OATH OF THE SPOUSE

STATE OF ARIZONA PINAL OF COUNTY

) )ss.

I have read, understood, and completed the above statements. Everything I have said is true and correct to the best of my knowledge, information and belief.

Signature SUBSCRIBED AND SWORN TO before me this day of 20 .

By My Commission Expires:
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Deputy Clerk/Notary Public
Name Change of Adult no Children Use most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

THE SUPERIOR COURT OF ARIZONA PINAL COUNTY
) ) ) ) ) ___________________________________)
In the Matter of:
Name(s) of person(s) who request(s) name change

CV 2___________________ NOTICE OF HEARING REGARDING APPLICATION FOR CHANGE OF NAME

READ THIS NOTICE CAREFULLY. An important court proceeding that affects your rights has been
scheduled. If you do not understand this Notice or the other court papers, contact an attorney for legal advice.

1.

NOTICE IS GIVEN that the Applicant has filed with the Court an Application for Change of Name. At
the hearing, the Court will consider whether to grant or deny the requested name change. If you wish to be heard on this issue, you must appear at the scheduled hearing.

2.

COURT HEARING. A court hearing has been scheduled to consider the Application as outlined
below:

DATED:
(Month/Day/Year)

Applicant's Signature

THE COURT COMPLETES THE FOLLOWING SECTION
DATE: LOCATION: BEFORE THE HONORABLE
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

TIME:

DIVISION
Name Change of Adult no Children Use most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

SUPERIOR COURT OF ARIZONA PINAL COUNTY
In the Matter of

) ) ) ) ) ) ss.

CV _2_____________________ AFFIDAVIT OF SERVICE BY CERTIFIED MAIL

Name of Applicant

STATE OF ARIZONA COUNTY OF PINAL

1.

I am familiar with the facts stated in this Affidavit, and I make this Affidavit to show that I have served copies of the "Application for Change of Name" and the "Notice of Hearing Regarding Application for Change of Name" on the person named below by certified mail/restricted delivery, return receipt requested. Person served (name of other party): Address where other party was served: Date of receipt by the other party:

2.

The Application and Notice listed above were received by the other party as shown by the receipt, the original of which is attached to this Affidavit on a separate piece of paper.

Signature

SUBSCRIBED AND SWORN TO before me this

day of

20

.

By My Commission Expires: Deputy Clerk/Notary Public

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version

IN THE SUPERIOR COURT OF ARIZONA PINAL COUNTY

In the Matter of

) ) ) ) )

CV

2______________________________

ORDER CHANGING NAME OF AN ADULT

Name of Applicant

THE COURT FINDS:
1. 2. 3.
This case has come before this Court to Change the Name of the Applicant. This Court has jurisdiction to change the name of the Applicant. Good cause exists to grant the application for Change of Name.

IT IS HEREBY ORDERED:
If the applicant was born in Arizona, the Office of Vital Records shall amend the birth certificate for ______________________________________ whose date of birth is ____________________ and whose place of birth is _______________________________ to reflect the new name of __________________________________________________________.
First Middle Last

This Order does not release the applicant named above from any obligations incurred or harm any rights of property or action in original name.

DONE IN OPEN COURT this

day of

20

Superior Court Judge/Special Commissioner

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Name Change of Adult no Children Use most current version