On October 02, 2017 a
Motion-Secondary
was filed
for Change of Name
in the District Court of Hennepin County.
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27mgv. 17v J W235
State of Minnesota District Court
County
“Wt?“ Judicial District:
Court File Number:
Case Type: Name Change
In the Matter of:
RXQ—
Lfifig LQQVUOQ
First 'ddle Last
Order Granting Name Change
And Other Relief
For a change of name to: (Minn. Stat. § 259.10, § 144.218, and § 144.2181)
‘
_\\
D
First iddle Last
The above entitled matter came on for hearing before the undersigned Judge on
upon the Application for a Name Change and Other Relief. Upon the
Date
testimony and files, THE COURT FINDS the following:
1. The application is made in good faith without intent to defraud or mislead.
2. The applicant(s) has/have lived in the State of Minnesota for at least six months preceding the filing
WWW
of the application, and now live at:7:534 \N LA ?\ 01,6 IOYOnQ HR) 551R \
Street J City/I’own State Zip
in Hmmt‘fifl County.
3. Name of applicant and date of bifihzw VLLG‘L‘ \Q%6‘
4. Name ofspouse and date ofbirth:
This application D does fl does not in de spouse.
5. Name(s) of minor children and date(s) of birth: N Pr
D This application does not include minor children listed above.
U This application includes the following minor children listed above: N Pr
NAM107 State ENG Rev 08/14 www.mncourts.govlforms Page 1 of 3
6. This applicant requests:
B To have his{her name changed to
_ \Cvo. L%Y\r\ \M
.
“$0“
D To have hjs/her name changed on birth records created or maintained by the Minnesota
Department of Health to
D To have his/her sex changed on birth records created or maintained by the Minnesota
Department of Health to
D To have the Minnesota Department of Health issue and register a replacement binh record. Applicant
further requests the prior bifih record be kept confidential and the replacement birth record not to
include any reference to Applicant’s D former name D former sex.
D To have the name of his/her spouse changed to
D To have the name(s) of his/her child (ren) changed to
7. The applicant (and included spouse or child (ren))
U Has not been convicted of a felony in any state.
E Has been convicted of a felony as followsz’fixch. \Ait’hh LquV-QXWLC \I
u ’LO\ 2.0 (5%
‘Fmgym b\wt cA— e
us "Damm- Cow ’r 'Dxem u’ mt Mom Dwm 0x
AND E Proper notice has been given to the prosecuting authority and Minnesota Attorney General
AND D No objection has been filed.
8. Legal description of lands in the State of Minnesota upon which the following have a claim, interest, or
lien: (Provide the legal description and attach additional pages if necessary.)
D Applicant HR
Espouse h fies \ ‘; K
‘ l ‘
?quL in
D Child (ren)\\)fi
CMM\ M1 V\ new0‘
'
\
'\
e 7
h \
Y0 fiY
>
De
9. Other:
The application is granted and IT IS ORDERED that:
D The legal name of the Applicant shall be
U The legal name of the spouse shall be
NAM107 State ENG Rev 08/14 www.mncourts.govlfonns Page 2 of 3
D The legal names of the minor child (ren) shall be
D The Minnesota Department of Health shall change the name on the birth record fiom
t0
D The Minnesota Department of Health shall change the sex on the birth record from to
D The Minnesota Department of Health shall issue and register a replacement bilth record for the Applicant.
The prior birth record shall be confidential pursuant to Minn. Stat. § 13.02, subdivision 3, and shall not be
disclosed except pursuant to court order.
D The replacement birth record shall not include any reference to the Applicant’s
D former name
D former sex
and
D shall reflect the Applicant’s current legal name of
D shall reflect the sex designation of
All persons having a criminal history who have been granted a name change by this
court have a duty to report that name change to the Bureau of Criminal Apprehension
Within ten (l0) days of this order.
D Other
Dated:
Judge of District Court
DUTY To REPORT NAME CHANGE
Minn. Stat. § 259.113
If you have a criminal history and have changed your name, you have a duty to report your name change to
the Bureau of Cn'minal Apprehension located at 1430 East Maryland Avenue, St Paul, MN 55106, (651)793-
2400, within ten (10) days of this order. Failure to do so is a gross misdemeanor punishable by up to one
(1) year in prison and/or a fine of $3000.
NAM1 07 State ENG Rev 08/14 www.mncourts.govlforms Page 3 of 3
Document Filed Date
October 02, 2017
Case Filing Date
October 02, 2017
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27mgv. 17v J W235 State of Minnesota District Court County “Wt?“ Judicial District: Court File Number: Case Type: Name Change In the Matter of: RXQ— Lfifig LQQVUOQ First 'ddle Last Order Granting Name Change And Other Relief For a change of name to: (Minn. Stat. § 259.10, § 144.218, and § 144.2181) ‘ _\\ D First iddle Last The above entitled matter came on for hearing before the undersigned Judge on upon the Application for a Name Change and Other Relief. Upon the Date testimony and files, THE COURT FINDS the following: 1. The application is made in good faith without intent to defraud or mislead. 2. The applicant(s) has/have lived in the State of Minnesota for at least six months preceding the filing WWW of the application, and now live at:7:534 \N LA ?\ 01,6 IOYOnQ HR) 551R \ Street J City/I’own State Zip in Hmmt‘fifl County. 3. Name of applicant and date of bifihzw VLLG‘L‘ \Q%6‘ 4. Name ofspouse and date ofbirth: This application D does fl does not in de spouse. 5. Name(s) of minor children and date(s) of birth: N Pr D This application does not include minor children listed above. U This application includes the following minor children listed above: N Pr NAM107 State ENG Rev 08/14 www.mncourts.govlforms Page 1 of 3 6. This applicant requests: B To have his{her name changed to _ \Cvo. L%Y\r\ \M . “$0“ D To have hjs/her name changed on birth records created or maintained by the Minnesota Department of Health to D To have his/her sex changed on birth records created or maintained by the Minnesota Department of Health to D To have the Minnesota Department of Health issue and register a replacement binh record. Applicant further requests the prior bifih record be kept confidential and the replacement birth record not to include any reference to Applicant’s D former name D former sex. D To have the name of his/her spouse changed to D To have the name(s) of his/her child (ren) changed to 7. The applicant (and included spouse or child (ren)) U Has not been convicted of a felony in any state. E Has been convicted of a felony as followsz’fixch. \Ait’hh LquV-QXWLC \I u ’LO\ 2.0 (5% ‘Fmgym b\wt cA— e us "Damm- Cow ’r 'Dxem u’ mt Mom Dwm 0x AND E Proper notice has been given to the prosecuting authority and Minnesota Attorney General AND D No objection has been filed. 8. Legal description of lands in the State of Minnesota upon which the following have a claim, interest, or lien: (Provide the legal description and attach additional pages if necessary.) D Applicant HR Espouse h fies \ ‘; K ‘ l ‘ ?quL in D Child (ren)\\)fi CMM\ M1 V\ new0‘ ' \ '\ e 7 h \ Y0 fiY > De 9. Other: The application is granted and IT IS ORDERED that: D The legal name of the Applicant shall be U The legal name of the spouse shall be NAM107 State ENG Rev 08/14 www.mncourts.govlfonns Page 2 of 3 D The legal names of the minor child (ren) shall be D The Minnesota Department of Health shall change the name on the birth record fiom t0 D The Minnesota Department of Health shall change the sex on the birth record from to D The Minnesota Department of Health shall issue and register a replacement bilth record for the Applicant. The prior birth record shall be confidential pursuant to Minn. Stat. § 13.02, subdivision 3, and shall not be disclosed except pursuant to court order. D The replacement birth record shall not include any reference to the Applicant’s D former name D former sex and D shall reflect the Applicant’s current legal name of D shall reflect the sex designation of All persons having a criminal history who have been granted a name change by this court have a duty to report that name change to the Bureau of Criminal Apprehension Within ten (l0) days of this order. D Other Dated: Judge of District Court DUTY To REPORT NAME CHANGE Minn. Stat. § 259.113 If you have a criminal history and have changed your name, you have a duty to report your name change to the Bureau of Cn'minal Apprehension located at 1430 East Maryland Avenue, St Paul, MN 55106, (651)793- 2400, within ten (10) days of this order. Failure to do so is a gross misdemeanor punishable by up to one (1) year in prison and/or a fine of $3000. NAM1 07 State ENG Rev 08/14 www.mncourts.govlforms Page 3 of 3