On March 28, 2024 a
Complaint,Petition
was filed
involving a dispute between
Plooy, Rosemarie Grace,
and
for Petition for Change of Gender and Issuance of New Birth Cert
in the District Court of San Bernardino County.
Preview
ATTORNEY on mm wrmour ATTORNEY gm: m m; MMWMV
mus Rosemarie Glace Pboy
rum MAME
smeawoaeu 2055 CentralAveApt 106
cm Highland sum CA moons, 92346 F l LED
TELEPHoue no (909) 341-3980 nxuo SUPERIOR ooua'r 0F CALIFORNIA
COUNTY or SAN esmwaomo
mun mess rjpboy@gmail.com
Anomsv FOR (rum
SUPEMORCOURTOFCAUFOMAOOUNTYOF SANBERNARDINO MAR 28 ZCC'i
unset mess 247 West Thitd Street
MNUNO ADDRE“
a" ”m" °°°‘
“mo“ M San Bemardino, CaMomia 92415
San Bernardino Justice Cents! 37. Imim gum, 53mm
PETmON OF (m); Rosematie Glace Plooy
PETITION FOR RECOGNITION OF CHANGE OF GENDER AND SEX
MMR
IDENTIFIER
[E AND CHANGE OF NAME CNSB 2§05188
[E AND ISSUANCE OF NEW CERTIFICATES
Before you oompbte this petition, road Instrucfions 1hr Filing Petition for Recognition of Change o! Gender and Sex Identifier, Name
Change, and Issuance o! New Certificates (form NC-300-INFO),
Nob:Youdonotneedtofibmhpotflionorobhhaoounomrinmtoobuinanewmifomiabimwemfieatoforyouoryourd'litd
mfloofing a change of your genderorl nowCalifomia marriage lame and conflicts roflocb'ng I change o! gender, You may use an
administrative process instead; see Heatth and Safety Code section 103426.
1, Pou'u'oner (praxnt name); Rosemarie Glace Plooy B18yunoldoroddoranquuesuan0tdor
recognizing the change o! pofitionor‘s gender and sex identifier to
a.
b.
E
m
female.
male.
c. D nonbinary.
2. PotifionorisaCnlifomiaMMMmksnmmaCafifomhbwmcorfiflateormmmmdoufificme.
3. E Pofiu’onorhualrudyobhinodadeaudnmdaamemmpofifiowmmmmfinmmminms.
Petifionoratuchuacertiflodoopyofmodoaoeofnamehangetombpoflfion.
(II this item is mocked, skip item 4 and indimte the request in item 5.)
4. m Pofifiomrmquommmoooundoaeemmonersnmbedungod.inordenoconfonnmpeflfioner'sgenderidonfity.
James Pboy
to(proposedname): RyIand
Thisistherightoounforthopofitiontodlanoename,becausepofiflm(drod((1)or(2).)
m
I.
rosidesinthiscounty.
ED
(1)
(2) doesnotmadoin California unamreckone):
wanuanamo change on moirorfinirdiild‘sbkmoemficfla,whichwuiuuodin thisoounty.
b.
B (i)
(ii) wnnuaname change onsmarriogeliwnsqandwumarriodinmb county.
mPotifionerroquommauhecoun'muoanorderdimdinganyimomtodpenomtofllewrmonobjedionstoshow
muuwhymopofib’onfamofnmshouldnotbogmnbd.
c. m NamandlnlonnafionAboMUwPoraoanName/stoBeChaigoMbm NC-110)isafiadledtomisform.
mg
gmmzmw
mum mxm sex
PETmou FOR Recocumou or CHANGE 0F GENDER AND mwmfig‘asgfm
NAME CHANGE, AND Issumce 0F new CERTIFICATEs
IDENTIFIER. mm~m
LHI6043 SAN BERNARDINO
SHORT TITLE: CASE NUMBER:
Petition oszosomarie Grace Plooy
5. m Issuance of Now Calflornla Com
1E Potiu’onerroquestslnorderfortheiuumceofanewbirhcorfiflcateforpoflfionermflodingmomngeofgender
Eandchangcofnnme.
D
b.
gender D
Petitionerroquests an orderforthe issuanceata newbirth oerfificuteforpefitioneh mild
Ind change of name.
nfleding petitioner‘s change of
(Attach Birth Certificate for Child of Pefitbmr—Altachmenl (form NC-31 1 ).)
c. D Potitionerroquuuan
pemnabride.
oMerfortheiuuanooofancwmarriagelioemmdcerfimmadungeofdodgmfion
groom. orhavingnenherboxchedted Eanddungeofnamo.
ofthe
(Attach Marriage License and Cedifimto—Attadzment (form NC-312).)
I
to (chock one)
idenh'ty and is
D female m male D
declare under penalty of perjury under the laws of the State of California that the request for a change
not for any fraudulent purpose.
nonbinary is to conform my legal gender and
in gender and sex identifier
ax identifier to my gender
Date:
Rosemarie Grace Ploog
(TYPEORPRINTNME NPE‘I’ITW)
(TYPE m PRINT Ma ATTMY) (mm a ATTMY)
WWW" Mm ‘-
FOR RECOGNITION OF CHANGE OF GENDER AND
PETITION
SEX IDENTIFIER. NM
CHANGE, AND ISSUANCE OF NEW CERTIFICATES
"'1'”
LHI6043 SAN BERNARDINO
Preview
ATTORNEY on mm wrmour ATTORNEY gm: m m; MMWMV mus Rosemarie Glace Pboy rum MAME smeawoaeu 2055 CentralAveApt 106 cm Highland sum CA moons, 92346 F l LED TELEPHoue no (909) 341-3980 nxuo SUPERIOR ooua'r 0F CALIFORNIA COUNTY or SAN esmwaomo mun mess rjpboy@gmail.com Anomsv FOR (rum SUPEMORCOURTOFCAUFOMAOOUNTYOF SANBERNARDINO MAR 28 ZCC'i unset mess 247 West Thitd Street MNUNO ADDRE“ a" ”m" °°°‘ “mo“ M San Bemardino, CaMomia 92415 San Bernardino Justice Cents! 37. Imim gum, 53mm PETmON OF (m); Rosematie Glace Plooy PETITION FOR RECOGNITION OF CHANGE OF GENDER AND SEX MMR IDENTIFIER [E AND CHANGE OF NAME CNSB 2§05188 [E AND ISSUANCE OF NEW CERTIFICATES Before you oompbte this petition, road Instrucfions 1hr Filing Petition for Recognition of Change o! Gender and Sex Identifier, Name Change, and Issuance o! New Certificates (form NC-300-INFO), Nob:Youdonotneedtofibmhpotflionorobhhaoounomrinmtoobuinanewmifomiabimwemfieatoforyouoryourd'litd mfloofing a change of your genderorl nowCalifomia marriage lame and conflicts roflocb'ng I change o! gender, You may use an administrative process instead; see Heatth and Safety Code section 103426. 1, Pou'u'oner (praxnt name); Rosemarie Glace Plooy B18yunoldoroddoranquuesuan0tdor recognizing the change o! pofitionor‘s gender and sex identifier to a. b. E m female. male. c. D nonbinary. 2. PotifionorisaCnlifomiaMMMmksnmmaCafifomhbwmcorfiflateormmmmdoufificme. 3. E Pofiu’onorhualrudyobhinodadeaudnmdaamemmpofifiowmmmmfinmmminms. Petifionoratuchuacertiflodoopyofmodoaoeofnamehangetombpoflfion. (II this item is mocked, skip item 4 and indimte the request in item 5.) 4. m Pofifiomrmquommmoooundoaeemmonersnmbedungod.inordenoconfonnmpeflfioner'sgenderidonfity. James Pboy to(proposedname): RyIand Thisistherightoounforthopofitiontodlanoename,becausepofiflm(drod((1)or(2).) m I. rosidesinthiscounty. ED (1) (2) doesnotmadoin California unamreckone): wanuanamo change on moirorfinirdiild‘sbkmoemficfla,whichwuiuuodin thisoounty. b. B (i) (ii) wnnuaname change onsmarriogeliwnsqandwumarriodinmb county. mPotifionerroquommauhecoun'muoanorderdimdinganyimomtodpenomtofllewrmonobjedionstoshow muuwhymopofib’onfamofnmshouldnotbogmnbd. c. m NamandlnlonnafionAboMUwPoraoanName/stoBeChaigoMbm NC-110)isafiadledtomisform. mg gmmzmw mum mxm sex PETmou FOR Recocumou or CHANGE 0F GENDER AND mwmfig‘asgfm NAME CHANGE, AND Issumce 0F new CERTIFICATEs IDENTIFIER. mm~m LHI6043 SAN BERNARDINO SHORT TITLE: CASE NUMBER: Petition oszosomarie Grace Plooy 5. m Issuance of Now Calflornla Com 1E Potiu’onerroquestslnorderfortheiuumceofanewbirhcorfiflcateforpoflfionermflodingmomngeofgender Eandchangcofnnme. D b. gender D Petitionerroquests an orderforthe issuanceata newbirth oerfificuteforpefitioneh mild Ind change of name. nfleding petitioner‘s change of (Attach Birth Certificate for Child of Pefitbmr—Altachmenl (form NC-31 1 ).) c. D Potitionerroquuuan pemnabride. oMerfortheiuuanooofancwmarriagelioemmdcerfimmadungeofdodgmfion groom. orhavingnenherboxchedted Eanddungeofnamo. ofthe (Attach Marriage License and Cedifimto—Attadzment (form NC-312).) I to (chock one) idenh'ty and is D female m male D declare under penalty of perjury under the laws of the State of California that the request for a change not for any fraudulent purpose. nonbinary is to conform my legal gender and in gender and sex identifier ax identifier to my gender Date: Rosemarie Grace Ploog (TYPEORPRINTNME NPE‘I’ITW) (TYPE m PRINT Ma ATTMY) (mm a ATTMY) WWW" Mm ‘- FOR RECOGNITION OF CHANGE OF GENDER AND PETITION SEX IDENTIFIER. NM CHANGE, AND ISSUANCE OF NEW CERTIFICATES "'1'” LHI6043 SAN BERNARDINO