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RECEIVED FOR SCANNING
VENTURA SUPERIOR COURT
_ _ NC-100
|ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUN
hae DOMME Laven Nickerson NOV 30 2022
| URM NAME:
street aooress ALS West Firse STrect
ery OXNaVA sit, CR recov A3030
TELEPHONE No:(POS) 3b - Gr0s FAXNO
Ewan aporess: Yadi 1148 & Qmar \-com
|ATTORNEY FOR (name)
ISUPERIOR COURT OF CALIFORNIA, COUNTY OF VV enwra
strEeTADDREss; @OO Sot Victoria Ave
MauNncanoriss: @OO Sovtn victoria Ave
cITy AND ZIP CODE: WENUTA QA2a004A
BRANCH NAME: FALL ef SUStICE
PETITION OF (name of each petitioner):
Donnell Lavon Nickersoyny
PETITION FOR CHANGE OF NAME
‘CASE NUMBER:
Before you complete this petition, you should read the Instructions for Filing a Petition for Change of Name (form NC-100-INFO). You
must answer all questions and check all boxes that apply to you on this petition. You must file this petition in the superior court of the
county where the person whose name is to be changed resides.
1. Petitioner (present name): DOWNE\\ Lavon Nickey sory resides in this county.
2. Petitioner requests that the court decree the following name changes (list every name that you are seeking to change):
Present name Proposed name
a Donne\\ Lavon Nickerson changedto DONYNE\\ Loavon Mogal\lanes
b. changed to
c. changed to
d. changed to
[-) Continued (if you are seeking to change additional names, you must prepare a list and attach it to this petition as
Attachment 2.)
3. Petitioner requests that the court issue an order directing all interested persons to appear or file objections to show cause why
this petition for change of name of the persons identified in item 2 should not be granted.
4, The number of persons under 18 years of age whose names are to be changed is (specify): ©
5. If this petition requests the change of name of any person or persons under 18 years, this request is being made by
a. [__] two parents.
. [_] one parent.
~ [- ] near relative (name and relationship):
[) guardian (name):
(J other (specify):
6. [J This petition seeks to change name of (check one) [—] petitioner [7] (name):
to conform to that person's gender identity.
eoaog
7. For each person whose name is to be changed, petitioner provides the following information (you must attach a completed copy of
the attachment Name and Information About the Person Whose Name Is to Be Changed (form NC-110) for each person identified in
item 2):
a. The number of attachments included in this petition is (specify number): AL
b-f. (These are the items on the attached page or pages of Form NC-110.)
Page 1 of 1
Sudial Crunen Caomin PETITION FOR CHANGE OF NAME Codec Cut Prete § 1278s
NNC-106 ;Rev. September 1, 2018} (Change of Name)
ém-sINSTRUCTIONS FOR FILING A PETITIO. NC-100-INFO
FOR CHANGE OF NAME
1, Where to File
The petition for change of name must be filed in the superior court of the county where the person whose name is to be changed is
a resident.
2. Whose Name May Be Changed
The petition may be used to change your own name and, under certain circumstances, the names of others (e.g., children under 18
years of age).
3. Confidentiality of Certain Names
If you are a participant in the Secretary of State's address confidentiality program (Safe at Home), your current and proposed names
may be kept confidential. (Code Civ. Proc., § 1277(b).) See Information Sheet for Name Change Proceedings Under Address
Confidentiality Program (Safe at Home) (form NC-400-INFO) for additional instructions.
4. What Forms Are Required
Prepare an original and two copies of each of the following documents:
a. Petition for Change of Name (form NC-100)
b. Name and Information About the Person Whose Name Is to Be Changed (Attachment to Petition For Change of Name) (form
NC-110) (attach as many copies as necessary)
c. Order to Show Cause for Change of Name (form NC-120) or, if applicable, Order to Show Cause for Change of Name to
Conform to Gender Identity (form NC-125)
d. Decree Changing Name (form NC-130 or, for guardians, form NC-130G)
e. Civil Case Cover Sheet (form CM-010)
In addition, a guardian must prepare and attach a Declaration of Guardian (Supplemental Attachment to Petition) (form NC-110G)
for each child whose name is to be changed.
5. Filing and Filing Fee
Prepare an original Civil Case Cover Sheet (form CM-010). File the original petition and Civil Case Cover Sheet with the clerk of
the court and obtain two filed-endorsed copies of the petition. A filing fee will be charged unless you qualify for a fee waiver. (If you
want to apply for a fee waiver, see Request to Waive Court Fees (form FW-001) and Information Sheet on Waiver of Court Fees
and Costs (form FW-001-INFO).
6. Requesting a Court Hearing Date and Obtaining the Order to Show Cause
You should request a date for the hearing on the Order to Show Cause for Change of Name (form NC-120) at least six weeks in the
future. Take the completed form to the clerk's office. The clerk will provide the hearing date and location, obtain the judicial officer's
signature, file the original, and give you a copy.
If you are changing your name to conform to gender identity, you need not request a hearing date. Instead, complete the Order to
Show Cause for Change of Name to Conform to Gender Identity (form NC-125) and take the completed form to the clerk's office.
The clerk will obtain the judicial officer's signature, file the original, and give you a copy.
7. Publishing the Order to Show Cause
In most cases, a copy of the Order to Show Cause must be published in a local newspaper of general circulation once a week for at
least four consecutive weeks before the date of the hearing. You must select the newspaper from among those newspapers
legally qualified to publish orders and notices. The newspaper used must file a Proof of Publication with the superior court before
the hearing. If no newspaper of general circulation is published in the county, the court may order the Order to Show Cause to be
posted by the clerk. But you do not have to publish the order if you are seeking to change a name to conform to your gender
identity or are a participant in (1) the State Witness Program, or (2) the address confidentiality program, and the petition alleges that
you are (a) petitioning to avoid domestic violence, or (b) petitioning to avoid stalking, or (c) a victim of sexual assault or petitioning
‘on behalf of one.
Page tof?
Ferm Approved fr Optional Use INSTRUCTIONS FOR FILING A PETITION vinn courts 2.904
Judica’ Council of Ca“fornia
NC-1.0-INFO [New September 1, 2018] FOR CHANGE OF NAMENC-100-INFO
8. Name Change for Children
a. If you are a petitioning parent requesting the name change for a child under 18 years of age, and one of the parents, if living,
does not join in consenting to the name change. the petitioning parent must have a copy of the Order to Show Cause or notice
of the time and place of the hearing served on the nonconsenting parent. Service must be made at least 30 days prior to the
hearing under Code of Civil Procedure sections 413.10, 414.10, 415.10, or 415.40.
b. If the nonconsenting parent resides in California, the order or notice must be personally served on the nonconsenting parent.
You cannot personally serve this document.
c. If the nonconsenting parent resides outside California, that parent may be served by sending a copy of the order or notice by
first-class mail, postage prepaid, return receipt requested.
d. {f you are the guardian of a minor and filing a petition to change the name of that child, you must (1) provide notice of the
hearing to any living parent of the child by personal service at least 30 days before the hearing, or (2) if either or both parents
are deceased or cannot be located, serve notice of the hearing on the child's grandparents, if living, not less than 30 days before
the hearing under Code of Civil Procedure sections 413.10, 414.10, 415.10, or 415.40.
If you have served a parent or grandparents, file a copy of the completed Proof of Service of Order to Show Cause (form NC-121)
with the court before the hearing
If the minor's name is being changed to conform to gender, these notices and orders need not be completed or served.
9. Name Change for Person in Jail or Prison or on Parole
If you are a person in county jail, or under the jurisdiction of the Department of Corrections and Rehabilitation (in state prison, or on
parole) you may file a petition to change your name, but must serve the petition on a government agency.
* — Ifin county jail, you must provide a copy of the petition to the county sheriffs department. Check with the department as to how
that should be done
* Ifin state prison, you must provide a copy of the petition to the warden. Check with the warden's office as to how that should be
done.
* Ifon parole, you must provide a copy of the petition to the regional parole administrator. Check with the administrator's office
as to how that should be done.
After you have provided a copy to the sheriff, warden, or regional parole administrator, file a copy of the completed Proof of
Service By Mail (form POS-030) with the court.
Note that the declaration on form NC-110 as to whether the petitioner is in jail or under jurisdiction of the California Department of
Corrections and Rehabilitation is only for purposes of determining if service of the petition is required.
10. Court Hearing
If no written objection is filed at least two court days before the scheduled hearing, the court may grant the petition and sign the
decree without a hearing. Check with the court to find out if a hearing will be held. If there is a hearing, bring copies of all
documents to the hearing. If the judge grants the petition, the judge will sign the original decree.
If you filed a petition for name change to conform to gender identity, and timely objections were filed, the court may set a hearing
date after receiving the objections. If it does, you will be sent a notice of the hearing date. Check with the court after the deadline for
filing objections to see if a hearing date has been set. If there are no objections, the court will grant the petition and sign the decree
without a hearing.
1
. If you were born in California and want to amend a birth certificate to show the name change, you should contact the following
office:
California Department of Public Health
Vital Records - MS 5103
P.O. Box 997410 Phone: 916-445-2684
Sacramento, CA 95899-7410 website: www.cdph.ca.gov
Local courts may supplement these instructions. Check with the court to determine whether supplemental information is available.
For instance, the court may provide you with additional written information identifying the department that handles name change
petitions, the times when petitions are heard, and the newspapers that may be used to publish the Order to Show Cause.
NC-100:NFO (Now September 1, 2016) INSTRUCTIONS FOR FILING A PETITION Page 2012
FOR CHANGE OF NAMENC-110
PETITION OF (Name of petitioner or petitioners): CASE NUMBER:
Donnell Lavan Nickerson _ ror cHance oF Name
NAME AND INFORMATION ABOUT THE PERSON
WHOSE NAME IS TO BE CHANGED Attachment 4 of A
Attachment to Petition (form NC-100, form NC-200, or form NC-500)
(You must use a separate attachment for each person whose name is to be changed. if petitioner is a guardian of a minor, a
supplemental attachment, Declaration of Guardian (form NC-110G), must also be completed and attached for each minor whose name
is to be changed.)
7. (Continued) Petitioner applies for a decree to change the name of the following person:
b. Self Other
BS eoent a (specify): DONNENN LAVON NICKEr Son
(2) Proposed name (specify): Donne\\ Lavon Magationes
(3) Bom on (date of birth): May 4, \AA3
and presently [__] under 18 years ofage [><] over 18 years of age
(4) Bom at (place of birth): OXWWard , CA
(8) Sex (as stated on original birth certificate): J>&) Male [_] Female
(6) Current residence address (street, city, county, and zip code): U2S west Fwst sivreex
omard CA 430380
c. Reason for name change (explain):
x never ene tne Persom who gave me the Nest wame Of Nickerson, TE was always
nm eNEr Since TF was tittle. amily with Maqal
d. wnionep of the petitioner to the person whose vance “ied Magallanes 420% me Mm and Qove me abo.
) BS seit (4) (-] near relative (indicate relationship):
(2) (__] parent (5) [] Other (specify):
(3) [£_) guardian
e. Ifthe person whose name will be changed is under 18 years of age, provide the names and addresses, if known, of the
following persons:
Parent (name): (address):
(2) Parent (name): (address):
(3) (Only if neither parent is living) Near relatives (names, relationships, and addresses):
f. If the person whose name will be changed is 18 years of age or older, that person must sign the following declaration:
DECLARATION
| declare under penalty of perjury under the laws of the State of California that (check one) lamnot ["_] lam
under the jurisdiction of the California Department of Corrections and Rehabilitation (in state prison or on parole) or in county
jail and (check one) BR lamnot [__] !am__ required to register as a sex offender under Penal Code section 290.
Date: 1/30/2022
INE vorn_NiCKerso
(TYPL OR PRINT NAME OF PERSON WHOSE NAME IS TO BE CHANGED) (SIGNATURE OF PERSON WHOSE NAME IS TO BE CHANGED)
(if petitioner is represented by an attorney, the attorney's signature follows):
Date:
»
(TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY)
(Each petitioner must sign this petition in the space provided below or, if additional pages are attached, at the end of the last
attachment.) | declare under penalty of perjury under the laws of the State of California that the information in the foregoing petition is
true and correct,
Date: Nf 30 | 2022
Donmnetl Lavon Nickerson WO Dacercl A flat leat at.
(TYPE OR PRINT NAME) « (ATURE OF PETITIONER)
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)
ADD ADDITIONAL SIGNATURE LINES FOR ADDITIONAL PETITIONERS SIGNATURE OF PETITIONERS FOLLOWS LAST ATTACHMENT Page 1 of 1
Form Adopted for Mandatory Use ATTACHMENT TO Code of Civ Procedure, § 1275 et seq.
Judic.s Councit of Ca"fornia /. COUNS.CB.
N-190 Rev. September 1.2018) PETITION FOR CHANGE OF NAME scons ca er
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RECEIVED FOR SCANNING VENTURA SUPERIOR COURT _ _ NC-100 |ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUN hae DOMME Laven Nickerson NOV 30 2022 | URM NAME: street aooress ALS West Firse STrect ery OXNaVA sit, CR recov A3030 TELEPHONE No:(POS) 3b - Gr0s FAXNO Ewan aporess: Yadi 1148 & Qmar \-com |ATTORNEY FOR (name) ISUPERIOR COURT OF CALIFORNIA, COUNTY OF VV enwra strEeTADDREss; @OO Sot Victoria Ave MauNncanoriss: @OO Sovtn victoria Ave cITy AND ZIP CODE: WENUTA QA2a004A BRANCH NAME: FALL ef SUStICE PETITION OF (name of each petitioner): Donnell Lavon Nickersoyny PETITION FOR CHANGE OF NAME ‘CASE NUMBER: Before you complete this petition, you should read the Instructions for Filing a Petition for Change of Name (form NC-100-INFO). You must answer all questions and check all boxes that apply to you on this petition. You must file this petition in the superior court of the county where the person whose name is to be changed resides. 1. Petitioner (present name): DOWNE\\ Lavon Nickey sory resides in this county. 2. Petitioner requests that the court decree the following name changes (list every name that you are seeking to change): Present name Proposed name a Donne\\ Lavon Nickerson changedto DONYNE\\ Loavon Mogal\lanes b. changed to c. changed to d. changed to [-) Continued (if you are seeking to change additional names, you must prepare a list and attach it to this petition as Attachment 2.) 3. Petitioner requests that the court issue an order directing all interested persons to appear or file objections to show cause why this petition for change of name of the persons identified in item 2 should not be granted. 4, The number of persons under 18 years of age whose names are to be changed is (specify): © 5. If this petition requests the change of name of any person or persons under 18 years, this request is being made by a. [__] two parents. . [_] one parent. ~ [- ] near relative (name and relationship): [) guardian (name): (J other (specify): 6. [J This petition seeks to change name of (check one) [—] petitioner [7] (name): to conform to that person's gender identity. eoaog 7. For each person whose name is to be changed, petitioner provides the following information (you must attach a completed copy of the attachment Name and Information About the Person Whose Name Is to Be Changed (form NC-110) for each person identified in item 2): a. The number of attachments included in this petition is (specify number): AL b-f. (These are the items on the attached page or pages of Form NC-110.) Page 1 of 1 Sudial Crunen Caomin PETITION FOR CHANGE OF NAME Codec Cut Prete § 1278s NNC-106 ;Rev. September 1, 2018} (Change of Name) ém-sINSTRUCTIONS FOR FILING A PETITIO. NC-100-INFO FOR CHANGE OF NAME 1, Where to File The petition for change of name must be filed in the superior court of the county where the person whose name is to be changed is a resident. 2. Whose Name May Be Changed The petition may be used to change your own name and, under certain circumstances, the names of others (e.g., children under 18 years of age). 3. Confidentiality of Certain Names If you are a participant in the Secretary of State's address confidentiality program (Safe at Home), your current and proposed names may be kept confidential. (Code Civ. Proc., § 1277(b).) See Information Sheet for Name Change Proceedings Under Address Confidentiality Program (Safe at Home) (form NC-400-INFO) for additional instructions. 4. What Forms Are Required Prepare an original and two copies of each of the following documents: a. Petition for Change of Name (form NC-100) b. Name and Information About the Person Whose Name Is to Be Changed (Attachment to Petition For Change of Name) (form NC-110) (attach as many copies as necessary) c. Order to Show Cause for Change of Name (form NC-120) or, if applicable, Order to Show Cause for Change of Name to Conform to Gender Identity (form NC-125) d. Decree Changing Name (form NC-130 or, for guardians, form NC-130G) e. Civil Case Cover Sheet (form CM-010) In addition, a guardian must prepare and attach a Declaration of Guardian (Supplemental Attachment to Petition) (form NC-110G) for each child whose name is to be changed. 5. Filing and Filing Fee Prepare an original Civil Case Cover Sheet (form CM-010). File the original petition and Civil Case Cover Sheet with the clerk of the court and obtain two filed-endorsed copies of the petition. A filing fee will be charged unless you qualify for a fee waiver. (If you want to apply for a fee waiver, see Request to Waive Court Fees (form FW-001) and Information Sheet on Waiver of Court Fees and Costs (form FW-001-INFO). 6. Requesting a Court Hearing Date and Obtaining the Order to Show Cause You should request a date for the hearing on the Order to Show Cause for Change of Name (form NC-120) at least six weeks in the future. Take the completed form to the clerk's office. The clerk will provide the hearing date and location, obtain the judicial officer's signature, file the original, and give you a copy. If you are changing your name to conform to gender identity, you need not request a hearing date. Instead, complete the Order to Show Cause for Change of Name to Conform to Gender Identity (form NC-125) and take the completed form to the clerk's office. The clerk will obtain the judicial officer's signature, file the original, and give you a copy. 7. Publishing the Order to Show Cause In most cases, a copy of the Order to Show Cause must be published in a local newspaper of general circulation once a week for at least four consecutive weeks before the date of the hearing. You must select the newspaper from among those newspapers legally qualified to publish orders and notices. The newspaper used must file a Proof of Publication with the superior court before the hearing. If no newspaper of general circulation is published in the county, the court may order the Order to Show Cause to be posted by the clerk. But you do not have to publish the order if you are seeking to change a name to conform to your gender identity or are a participant in (1) the State Witness Program, or (2) the address confidentiality program, and the petition alleges that you are (a) petitioning to avoid domestic violence, or (b) petitioning to avoid stalking, or (c) a victim of sexual assault or petitioning ‘on behalf of one. Page tof? Ferm Approved fr Optional Use INSTRUCTIONS FOR FILING A PETITION vinn courts 2.904 Judica’ Council of Ca“fornia NC-1.0-INFO [New September 1, 2018] FOR CHANGE OF NAMENC-100-INFO 8. Name Change for Children a. If you are a petitioning parent requesting the name change for a child under 18 years of age, and one of the parents, if living, does not join in consenting to the name change. the petitioning parent must have a copy of the Order to Show Cause or notice of the time and place of the hearing served on the nonconsenting parent. Service must be made at least 30 days prior to the hearing under Code of Civil Procedure sections 413.10, 414.10, 415.10, or 415.40. b. If the nonconsenting parent resides in California, the order or notice must be personally served on the nonconsenting parent. You cannot personally serve this document. c. If the nonconsenting parent resides outside California, that parent may be served by sending a copy of the order or notice by first-class mail, postage prepaid, return receipt requested. d. {f you are the guardian of a minor and filing a petition to change the name of that child, you must (1) provide notice of the hearing to any living parent of the child by personal service at least 30 days before the hearing, or (2) if either or both parents are deceased or cannot be located, serve notice of the hearing on the child's grandparents, if living, not less than 30 days before the hearing under Code of Civil Procedure sections 413.10, 414.10, 415.10, or 415.40. If you have served a parent or grandparents, file a copy of the completed Proof of Service of Order to Show Cause (form NC-121) with the court before the hearing If the minor's name is being changed to conform to gender, these notices and orders need not be completed or served. 9. Name Change for Person in Jail or Prison or on Parole If you are a person in county jail, or under the jurisdiction of the Department of Corrections and Rehabilitation (in state prison, or on parole) you may file a petition to change your name, but must serve the petition on a government agency. * — Ifin county jail, you must provide a copy of the petition to the county sheriffs department. Check with the department as to how that should be done * Ifin state prison, you must provide a copy of the petition to the warden. Check with the warden's office as to how that should be done. * Ifon parole, you must provide a copy of the petition to the regional parole administrator. Check with the administrator's office as to how that should be done. After you have provided a copy to the sheriff, warden, or regional parole administrator, file a copy of the completed Proof of Service By Mail (form POS-030) with the court. Note that the declaration on form NC-110 as to whether the petitioner is in jail or under jurisdiction of the California Department of Corrections and Rehabilitation is only for purposes of determining if service of the petition is required. 10. Court Hearing If no written objection is filed at least two court days before the scheduled hearing, the court may grant the petition and sign the decree without a hearing. Check with the court to find out if a hearing will be held. If there is a hearing, bring copies of all documents to the hearing. If the judge grants the petition, the judge will sign the original decree. If you filed a petition for name change to conform to gender identity, and timely objections were filed, the court may set a hearing date after receiving the objections. If it does, you will be sent a notice of the hearing date. Check with the court after the deadline for filing objections to see if a hearing date has been set. If there are no objections, the court will grant the petition and sign the decree without a hearing. 1 . If you were born in California and want to amend a birth certificate to show the name change, you should contact the following office: California Department of Public Health Vital Records - MS 5103 P.O. Box 997410 Phone: 916-445-2684 Sacramento, CA 95899-7410 website: www.cdph.ca.gov Local courts may supplement these instructions. Check with the court to determine whether supplemental information is available. For instance, the court may provide you with additional written information identifying the department that handles name change petitions, the times when petitions are heard, and the newspapers that may be used to publish the Order to Show Cause. NC-100:NFO (Now September 1, 2016) INSTRUCTIONS FOR FILING A PETITION Page 2012 FOR CHANGE OF NAMENC-110 PETITION OF (Name of petitioner or petitioners): CASE NUMBER: Donnell Lavan Nickerson _ ror cHance oF Name NAME AND INFORMATION ABOUT THE PERSON WHOSE NAME IS TO BE CHANGED Attachment 4 of A Attachment to Petition (form NC-100, form NC-200, or form NC-500) (You must use a separate attachment for each person whose name is to be changed. if petitioner is a guardian of a minor, a supplemental attachment, Declaration of Guardian (form NC-110G), must also be completed and attached for each minor whose name is to be changed.) 7. (Continued) Petitioner applies for a decree to change the name of the following person: b. Self Other BS eoent a (specify): DONNENN LAVON NICKEr Son (2) Proposed name (specify): Donne\\ Lavon Magationes (3) Bom on (date of birth): May 4, \AA3 and presently [__] under 18 years ofage [><] over 18 years of age (4) Bom at (place of birth): OXWWard , CA (8) Sex (as stated on original birth certificate): J>&) Male [_] Female (6) Current residence address (street, city, county, and zip code): U2S west Fwst sivreex omard CA 430380 c. Reason for name change (explain): x never ene tne Persom who gave me the Nest wame Of Nickerson, TE was always nm eNEr Since TF was tittle. amily with Maqal d. wnionep of the petitioner to the person whose vance “ied Magallanes 420% me Mm and Qove me abo. ) BS seit (4) (-] near relative (indicate relationship): (2) (__] parent (5) [] Other (specify): (3) [£_) guardian e. Ifthe person whose name will be changed is under 18 years of age, provide the names and addresses, if known, of the following persons: Parent (name): (address): (2) Parent (name): (address): (3) (Only if neither parent is living) Near relatives (names, relationships, and addresses): f. If the person whose name will be changed is 18 years of age or older, that person must sign the following declaration: DECLARATION | declare under penalty of perjury under the laws of the State of California that (check one) lamnot ["_] lam under the jurisdiction of the California Department of Corrections and Rehabilitation (in state prison or on parole) or in county jail and (check one) BR lamnot [__] !am__ required to register as a sex offender under Penal Code section 290. Date: 1/30/2022 INE vorn_NiCKerso (TYPL OR PRINT NAME OF PERSON WHOSE NAME IS TO BE CHANGED) (SIGNATURE OF PERSON WHOSE NAME IS TO BE CHANGED) (if petitioner is represented by an attorney, the attorney's signature follows): Date: » (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY) (Each petitioner must sign this petition in the space provided below or, if additional pages are attached, at the end of the last attachment.) | declare under penalty of perjury under the laws of the State of California that the information in the foregoing petition is true and correct, Date: Nf 30 | 2022 Donmnetl Lavon Nickerson WO Dacercl A flat leat at. (TYPE OR PRINT NAME) « (ATURE OF PETITIONER) Date: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) ADD ADDITIONAL SIGNATURE LINES FOR ADDITIONAL PETITIONERS SIGNATURE OF PETITIONERS FOLLOWS LAST ATTACHMENT Page 1 of 1 Form Adopted for Mandatory Use ATTACHMENT TO Code of Civ Procedure, § 1275 et seq. Judic.s Councit of Ca"fornia /. COUNS.CB. N-190 Rev. September 1.2018) PETITION FOR CHANGE OF NAME scons ca er