Document for In Re: Terrica Osby

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                                DEKALB COUNTY SUPERIOR COURT

                                             STATE OF GEORGIA

       the Name Change of Child(ren):
                   iCholette.                                      Civil Action

                                                                   Case Number




Tarrite Osby
                              etitioner,
VS.


      Nicholas \phngon.
                            Respondent.



                                CONSENT TO CHANGE NAME(S)
                                  OF MINOR CHILD(REN) and
                             ACKNOWLEDGEMENT OF SERVICE

                                                               1
         My name is           h iho                         Son
My address is: at HW                N. Belvine              Bud           Ectest       \cles, SC             24 ad!
My relationship to the child(ren) in this action is:                    [Check only one of the following.]
                          Parent                         [1]       Person Acting as Guardian.


                                                            2
         I have received a copy of the Petition being filed by“ l2 {ita Ooh
to change the name(s) of the child(ren), and I hereby give my consent to the hame(s)


Consent
   to Change Names of Minor Children
                                 — Rev. 10/24/01 - Tech. Rev. 10-2015; last rev 11-2021 Page 1 of 2
Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society
being changed as follows:


       Current Name of Child                         Year of Birth                Proposed New Name


b Va Nicholette O54                                   20\0- Dvn Nicholetle Oday \plpsow




                                                           3

         I consent to both jurisdiction and venue as they are stated in the Petition.                    So long
as any final order in this action is consistent with this consent form, then I waive formal
process, further notice, my right to a hearing and, if I am on active duty in the armed
forces, I also waive my rights under the Servicemembers Civil Relief Act, 50 USC
Appendix §521. I give my consent for the Court to hear this matter as soon as possible
after thirty days. Should further notice be required for any reason, the notice should be
mailed to me at the address shown in Paragraph One above.




                                                                (Check one & sign in front of Notary Public)

Nitholas Sohnsan
appeared before me on                /gt
               ul                      20. 4,
and stated under oath that they had read
the foregoing document, understood it,
and signed it voluntarily in my




Commission expires: (/na./2, 202?
Consent to Change Names of Minor Children        — Rev. 10/24/01 - Tech. Rev. 10-2015; last rev 11-2021 Page 2 of 2
Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society