Petition Name Change

Cal. Super. - 6th Dist.December 4, 2020

NC-100 ATTO’RNEY OR PARTY WITHOUT ATTOR STATE BAR NUMBER:W lmvlf/Lafl: WILL Whig: waef MSTREETADDRESS: ?‘?p 5‘ iL’Qj/‘W flavaLD .ny gMom; TATE:M 1P CODE: 9 £0? .~ -. M WVfi%p S zEEEPHONE N0; W} fy, 96‘ 9 FAX NO;E-MAIL ADDRESS: ATTORNEY FOR (name): Ma Y [ChiChwffi ?‘WLQwZZE @341 SUPERIOR COURT 0F CALIFORNIA, COUNTY 0F U ; r m COW}STREET ADDRESS: 191 NOTH FIRST STREET ' - . y o! Santa CIaHa MAILING ADDRESS: 191 NORTH FIRST STREET ' DEPL TY CITY AND ZIP CODE: SAN JOSE. CA 951 13 BRANCH NAME: PROBATE DEPARTMENT PETITION OF (name of each petitioner): CASENUMQR: z 5) CEPETITION FOR CHANGE OF NAME 0 C V 3?’ 8 "’ J Before you complete this petition, you should read the Instructions for Filing a Petition for Change ofName (form NC-1 OO-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 (p-resenfname): W 0 RIC! N E rt Y ‘ wo L l E resides in this county. 2. Petitioner requests that the court decree the following name changes (list every name that you are seeking 2‘0 change):W Proposed name a-ROBE L KIA5m Womcmmchangedm RaBEL momma: K1437? b. _ changedto c. changedto d. Changedto E Continued (ifyou are seeking to change additional names, you must prepare a list and afiach it 2‘0 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 ofthe 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 i5 (specify): L 5. lfthis petition requests the change of name of any person or persons under 18 years, this request is being made by . E two parents. . E one parent. - E nearrelative (name and relationship): . E guardian (name): - E other (specify): 6. E This petition seeksto change name of (check one) E petitioner E (name): ROBEL ILLORK’ Wt H to conform to that person's gender identity. - ‘ M I4 L E 7. For each person whose name is to be changed. petitioner provides the following information (you must attach a completed copy of the afiachment Name and Information About the Person Whose Name ls to Be Changed (form NC-110) for each person identifiedin item 2): a. The number of attachments included in this petition is (specify number): i 00.050) b-f. (These are the items on the attached page 0r pages of form NC-1 10.) Page1 of 1 Form Adopted for Mandatory Use Code of Civil Procedure. 1275 e! se .Judicial Council 0f California PETITION F0R CHANGE OF NAME vra/wécouns.ca.goqvNC-1oo [Rev‘ September 1. 2018] (Change of Name) NC-1 10 PETITION OF (Name of petitioner or petitioners): CASE NUMBER: > )A/flRK‘ N E rt. KIA §f4 LN 0 [F'OIR EANGE OF NAME gMCWWM NAME AND INFORMATION ABOUT THE PERSON WHOSE NAME IS TO BE CHANGED Attachment of 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. lfpetitioneris a guardian of a minor, a supplemental attachment, Declaration of Guardian (form NC-1 106), must also be completed and attached for each minor whose name is to be changed.) 7. (Continued) Petitioner plies for a decree to change the name ofthe following personumsaf Other ROBEL Kflgf/J LMgRKHVEH(1) Present name (specify). (2) Proposed name (speciM: R0 B E L, WORK] NEH F A ff” (3) Born on (date ofbirth). 1i / 13 I Z” L9 9M#acflaand presently E under 18 years of age E over 18 years of age (4) Born at(place ofbirfh): 5L S B CLYCOIM f} V6 J 5M 505,81 6A3 5 UQUeYUmgdl (5) Sex (as stated on origina bin‘h cediflcate): E Male E Female WW_ (6) Current residence address (street, city, county, and zip code). L , -0 ${an M VALIMY ,an gm pr Mafiaafl Ac. Reason or name change (explain): Me H n W” E , d. Relationship ofthe petitioner to the person whose name will be changed. n ME/ (1) E self (4) E near relative (indicate relationship): (2) E Parent (5) E Other(specify): (3) E guardian e. Ifthe person whose name will be changed is under 18 years of age provide the names and addresses, if known ofthe following persons. a M’(\ (1) parent (name). ‘flD'fF'I V16}\ waif 6 (address) B ?v mefiMW fldItW-fflr/‘fifl fig;?fld (2) Parent (name). Emepr-f FCMGQ’C (address). 2?? ihajwicw 7 > 7 7 7 > (3) (Onlyifneitherparentis living) Near relatives (names, relationships, and addresses). f. lfthe person whose name win be changed is 18 years 0f age or older, that person must sign the following declaration: DECLARATION | declare under penalty of perjury under the laws ofthe State of California that {check one) E l am not E I am under the jurisdiction of the California Department of Corrections and Rehabilitation (in state prison or on parole) or in county jail and (Check one) E 1 am not E l am required to register as a sex offender under Penal Code section 290. Date: é (TYPE OR PRINT NAME OF PERSON WHOSE NAME IS TO BE CHANGED) (SIGNATURE 0F PERSON WHOSE NAME IS TO BE CHANGED) (pretitioneris 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 additionalpages are attached, at the end of the last attachment.) l declare under penalty of perjury under the laws of the State of California that the information In the foregoing petition'Is true and corr Dateh‘mp C/H/zflflo - LLMYF r1814 7/00/th é fi‘mfl (TYPE 0R PRINT NAME) (SIGNATUREFQE;IT-IZNER) Date: g/ZZQL120 _____ [AMCM11/ a 9 apt f (TYPE OR PRINT NAME)__\ ((SIGNATUREbE PETITIONER)E ADD ADDITIONAL SIGNAU ELINE‘S‘FOR ADDITIONAL PETITIONERS SIGNATURE 0F PETITIONERS FOLLOWS LAST ATTACHMENT page1 0H Form Adopted far Mandatory Use ATTACHMENT TO Code of Civil Procedure, §1275 ei seq, Judicial Council of California 4 www.courtscagov Nc-110[Rev.September1.201a] PETITION FOR CHANGE OF NAME