On July 03, 2023 a
Pet Filed in FC - Name Change
was filed
for FC Change of Name
in the District Court of St. Louis County.
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IN THE CIRCUIT COURT OF MISSOURI
(County where court is located. City of Saint Louis is considered a county.)
In re:
Dani elle Nicole, Critzas Case
83SL-DELOWNE3
(First Name) (Middle Name) (Last Name) (Jr/Sr) Number
Petitioner (Enter your full legal name above) (Will be assigned when case is‘filed)
Division
Number ao
Will be assigned when case is filed)
“ELED
Petition for Change of Name (For Adult individual
Your Information (You are the “Petitioner” in this case)
JUL 03 2023
1 My current full legal name is:
CritZas _ JOAN M. SILMER
Danielle Nicole, F 7 CIR COUNTY
(First Name) (Middle Name) (Last Name) -
My full legal name at birth (prior to first marriage) was. (Check one of the two boxes):
oO
(First Name) (Middle Name) (Last Name) (Jr/Sr All)
x Same as current full legal name.
| want to change my name to:
wne,| Le Nicole Cnitzas—Murphy a
Name) (Middle Name) (Last Name) (r/Sr Ml)
Check one of the two boxes.
A This is the first petition [:have filed in this case. (Original Petition)
This is the second‘petition | have filed in this case.
My mailing address is:
\I$ad Tesco Dr.
(Street)
alt: OuiS Mo L826
-248-\A4(0
(State)
314-4 Number with Area Code)
My parent's full legal name is:
Miche lic. Louse
(First Name) (Middle Name) (Maiden Name - if applicable) Catzas —_ Or78rAM)
Petition for Change of Name (For Adult Individual) Page 1 of 5
Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent mo.gov
My other parent's (father or mother) full legal name is:
hae Cvitzas
(First Name) (Middle Name) (Maiden Name - if applicable) (Last Name) (Jr/SrMl)
My husband's or wife’s full legal name is:
Dawe Scott Murohuy
(First Name) (Middle Name) (Last Name)' J Gr/Sr/il)
My birth date is: _O 2A 194 (
10. My place of birth is Valencia CA USA
(City) (State) (Country)
11 The change of my name would not be detrimental to any other person.
12 | want to change my name because: -
My lacie aid Tr Wavit to Svar lastn our last
13. | reside in PX the United States [] another country, whichis:
14. [reside in the State of Mi SSoAt!
15 | reside in the Countyof Saint Lous
16. Check one of the two boxes.
PX My name has never been changed.
(0 My name has previously been:changed as follow:
ber. in. ind.
judas
17 Check all:boxes that apply.
(J | amithe victim of a crime based upon domestic violence as defined in §455.010, RSMo.
[_ kam the victim of child abuse as.defined in §210.110, RSMo.
[2] | am the victim of abuse by a family or household member as defined in §455.010, RSMo.
<5 JX None of the above.
Petition for Change of Name (For Adult Individual) Page 2 of 5
Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent.mo.gov
18. Check one of the two boxes.
‘KI There are no unsatisfied money judgments against me.
Oo There are unsatisfied money judgments against me in the following cases:
me and: the case.in the judgm
judgment is entered.
19. Check one of the two boxes.
K There are no cases requesting money pending against me.
(1 The following cases in which money is requested are pending against m
‘name.and-numbe! ‘court in. whi ing
Children’s Information
20. ' have child(ren’ 0 is/are listed below.
nt! ber.of iren.above. II
‘of each chil ve itd ‘al ‘an
, (First Name) (widcle Hama} (Last Name) Gr/srl (Child’s Age)
(Street) (City) (State) (Zip)
iFirst Name) (Middle Name) (Last Name) (dr/SrAll) (Child's Age)
(Street) (City) (State) (Zip;
FastNarie) (Middle Name) (Last Name) (St /Sr All) (Child's Age)
4
(Stood (City) (State) Zip)
(First Name) (Middle Name) (Last Name) Gr/Sr/N) (Child’s Age)
(Street) (City) (State) (Zip)
Petition for Change of Name (For Adult Individual) Page 30f5
Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent mo.gov
(First Name) (Middle Name) (Last Name) (Sr/SrMl) (Child's Age)
(Street) (City) (State) (Zip}
f.
(First Name) (Middle Name) (Last Name) (Ur /SrAll) (Child's Age)
(Street) (City) (State) (Zip)
Request for Relief
THEREFORE, | ask the court to change my name from the name stated in Paragraph 4 above to the
name stated in Paragraph 3 above.
Sign Below in the Presence of a Notary Public
Petitioner, of lawful age, being duly sworn on his or her oath, states.that he or she is the petitioner named
above and that the facts stated in this Petition for Change of Name*(For Adult Individual) are true according
to his or her Cee
.
vt V
(Sign above in the presence of a Notary PGblic) (Print your name above)
The following information must be completed:by a notary public.
STATE OF ple _)
COUNTY
OF St Ler )
On this 26 day.of dune 2023 , before me personally appeared,
to me known to be the person described in and
who executed the foregoing. instrument and acknowledged that he/she executed the same as his/her free
act and deed. -
IN WITNESS WHEREOF, | have hereunto set my hand and affixed my official seal in the County and
State aforesaid, ‘the day and year first above written,
~~,
—
eau VASIT2 Notary Public
ak Covi 3 County, State of Missouri
=
Kar vashr
‘Notary Public - Notary Seal
My commission expires KS. 2225 Missour
‘iy Socrinson Exposi CountyAut 25,2025
Gommiision#21
Petition for Change of Name (For Adult Individual) Page 4 of 5
Form CAFC401 07/22/2022 This form is available for free at www-selfrepresent.mo.gov
Attorney Information
int
the in attorn
| have assisted Petitioner in the preparation of these pleadings, but | am not entering my
appearance on behalf of Petitioner.
(Attorney - Sign above) (Missouri Bar Number)
(Attorney - Print your name above)
(Street)
(City) (State) (Zip) +
(Telephone Number with Area Code) (Fax Number with Area Code) (E-mail Address * Optional)
Petition for Change of Name (For Adult Individual) Page 5 of 5
Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent mo.gov
Document Filed Date
July 03, 2023
Case Filing Date
July 03, 2023
Category
FC Change of Name
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IN THE CIRCUIT COURT OF MISSOURI (County where court is located. City of Saint Louis is considered a county.) In re: Dani elle Nicole, Critzas Case 83SL-DELOWNE3 (First Name) (Middle Name) (Last Name) (Jr/Sr) Number Petitioner (Enter your full legal name above) (Will be assigned when case is‘filed) Division Number ao Will be assigned when case is filed) “ELED Petition for Change of Name (For Adult individual Your Information (You are the “Petitioner” in this case) JUL 03 2023 1 My current full legal name is: CritZas _ JOAN M. SILMER Danielle Nicole, F 7 CIR COUNTY (First Name) (Middle Name) (Last Name) - My full legal name at birth (prior to first marriage) was. (Check one of the two boxes): oO (First Name) (Middle Name) (Last Name) (Jr/Sr All) x Same as current full legal name. | want to change my name to: wne,| Le Nicole Cnitzas—Murphy a Name) (Middle Name) (Last Name) (r/Sr Ml) Check one of the two boxes. A This is the first petition [:have filed in this case. (Original Petition) This is the second‘petition | have filed in this case. My mailing address is: \I$ad Tesco Dr. (Street) alt: OuiS Mo L826 -248-\A4(0 (State) 314-4 Number with Area Code) My parent's full legal name is: Miche lic. Louse (First Name) (Middle Name) (Maiden Name - if applicable) Catzas —_ Or78rAM) Petition for Change of Name (For Adult Individual) Page 1 of 5 Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent mo.gov My other parent's (father or mother) full legal name is: hae Cvitzas (First Name) (Middle Name) (Maiden Name - if applicable) (Last Name) (Jr/SrMl) My husband's or wife’s full legal name is: Dawe Scott Murohuy (First Name) (Middle Name) (Last Name)' J Gr/Sr/il) My birth date is: _O 2A 194 ( 10. My place of birth is Valencia CA USA (City) (State) (Country) 11 The change of my name would not be detrimental to any other person. 12 | want to change my name because: - My lacie aid Tr Wavit to Svar lastn our last 13. | reside in PX the United States [] another country, whichis: 14. [reside in the State of Mi SSoAt! 15 | reside in the Countyof Saint Lous 16. Check one of the two boxes. PX My name has never been changed. (0 My name has previously been:changed as follow: ber. in. ind. judas 17 Check all:boxes that apply. (J | amithe victim of a crime based upon domestic violence as defined in §455.010, RSMo. [_ kam the victim of child abuse as.defined in §210.110, RSMo. [2] | am the victim of abuse by a family or household member as defined in §455.010, RSMo. <5 JX None of the above. Petition for Change of Name (For Adult Individual) Page 2 of 5 Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent.mo.gov 18. Check one of the two boxes. ‘KI There are no unsatisfied money judgments against me. Oo There are unsatisfied money judgments against me in the following cases: me and: the case.in the judgm judgment is entered. 19. Check one of the two boxes. K There are no cases requesting money pending against me. (1 The following cases in which money is requested are pending against m ‘name.and-numbe! ‘court in. whi ing Children’s Information 20. ' have child(ren’ 0 is/are listed below. nt! ber.of iren.above. II ‘of each chil ve itd ‘al ‘an , (First Name) (widcle Hama} (Last Name) Gr/srl (Child’s Age) (Street) (City) (State) (Zip) iFirst Name) (Middle Name) (Last Name) (dr/SrAll) (Child's Age) (Street) (City) (State) (Zip; FastNarie) (Middle Name) (Last Name) (St /Sr All) (Child's Age) 4 (Stood (City) (State) Zip) (First Name) (Middle Name) (Last Name) Gr/Sr/N) (Child’s Age) (Street) (City) (State) (Zip) Petition for Change of Name (For Adult Individual) Page 30f5 Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent mo.gov (First Name) (Middle Name) (Last Name) (Sr/SrMl) (Child's Age) (Street) (City) (State) (Zip} f. (First Name) (Middle Name) (Last Name) (Ur /SrAll) (Child's Age) (Street) (City) (State) (Zip) Request for Relief THEREFORE, | ask the court to change my name from the name stated in Paragraph 4 above to the name stated in Paragraph 3 above. Sign Below in the Presence of a Notary Public Petitioner, of lawful age, being duly sworn on his or her oath, states.that he or she is the petitioner named above and that the facts stated in this Petition for Change of Name*(For Adult Individual) are true according to his or her Cee . vt V (Sign above in the presence of a Notary PGblic) (Print your name above) The following information must be completed:by a notary public. STATE OF ple _) COUNTY OF St Ler ) On this 26 day.of dune 2023 , before me personally appeared, to me known to be the person described in and who executed the foregoing. instrument and acknowledged that he/she executed the same as his/her free act and deed. - IN WITNESS WHEREOF, | have hereunto set my hand and affixed my official seal in the County and State aforesaid, ‘the day and year first above written, ~~, — eau VASIT2 Notary Public ak Covi 3 County, State of Missouri = Kar vashr ‘Notary Public - Notary Seal My commission expires KS. 2225 Missour ‘iy Socrinson Exposi CountyAut 25,2025 Gommiision#21 Petition for Change of Name (For Adult Individual) Page 4 of 5 Form CAFC401 07/22/2022 This form is available for free at www-selfrepresent.mo.gov Attorney Information int the in attorn | have assisted Petitioner in the preparation of these pleadings, but | am not entering my appearance on behalf of Petitioner. (Attorney - Sign above) (Missouri Bar Number) (Attorney - Print your name above) (Street) (City) (State) (Zip) + (Telephone Number with Area Code) (Fax Number with Area Code) (E-mail Address * Optional) Petition for Change of Name (For Adult Individual) Page 5 of 5 Form CAFC401 07/22/2022 This form is available for free at www.selfrepresent mo.gov