Petition Name Change

Cal. Super. - 6th Dist.April 1, 2021

l NC-1DD ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER; NAME Thuy Tien Thi Nguyen FIRM NAME: STREET ADDRESS 2455 Amaryl Dr CITY: San Jose STATE: Ca ZIP 000595132 rELEF-Hone ~0.. 550-593-9504 FAx m: E-MAILADDRESS: knguyen.2181 @gmail.com A'I'I'ORNEY FOR(name): in Pro Per SUPERIOR COURT 0F CALIFORNIA, COUNTY OF Santa Clara STREET ADDRESS: 1 91 North First Street MNLINGADDRESS? 191 North First Street CFI'Y AND ZIP CODESan Jose Ca 951 1 3 BRANCH NAME; Civil PETITION OF {name Of each petitioner): Thuy Tien Thi Nguyen EILEE APR 0 1 2021 PETITION FOR CHANGE OF NAME CAseugfiR:C V3 7 8 9 7 6 county where the parspn whose name ls to be changed resides. 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 1. Petitionermresentname): ThuyTien ThiNguyen resides in this county. 2. Petitioner requests that the court decree the following name changes (list every name that you are seeking to change): Presgnt name Eropgsed name a. Thuy Tien Thi Nguyen changed to Tien Thi Thuy Nguyen b. ’ changed t0 c. changed t0 d. ‘ changed t0 D Continued {ifyou 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): 0 1 . . 5. If this petition reque‘sts the change of name of any person or persons under 18 years. this request Is being made by a. E two parents.E one paren‘t. |:| near relative (name and relationship):D guardian (name):D other (specify): 6. E This petition seeks to change name of (check one) E petitioner to conform to that person's gender identity. PP-F’P’ E (name): 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 ls t0 Be Changed (form NC--110) for each person identified'In item 2). 1 a. The number of éttachments included in this petition is (speciij/ number): 1 b-f. (These are the items on the attached page or pages of farm NC-1 10.) Page 1 of1 53332.3“8531‘iéfléi’F-fffizm r PETITION FOR CHANGE 0F NAME Nc-1oo [Rem September 1.201s] V (Change of Name) For your protection and privacy, please press the Clear Coda of Civil Procedure. § 1275 at seq. www(oour!s.ca,gov Thls Form button afleryou have printed the form. lpnntth1§"fo“fm i I save this’form I NC-110 PETITION OF {Name ofpeb‘floner or petitioners): CASE NUMBER: Thuy Tien Thi Nguyen FOR CHANGE OF NAME NAME AND INFORMATION ABOUT THE PERSON ' WHOSE NAME ls To BE CHANGED Attachment 1 or T Attachment to Petition (form NC-100. form Nc-ZOO, or form NC-SOO) (You mus! 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 b9 completed and attached for each minor whose name is to be changed.) 7. (Continued) Petitioner applies for a decree t0 change the name of the following person: b. E Self E Other (1) Present name (specify): Thuy Tien Thi Nguyen (2) Proposed name (specify): Tien Thi Thuy Nguyen (3) Born on (date ofbirrh): Januarv 23. 1967 and presently D under 1B years of age E over 18 years of age (4) Born at (place ofbirth): Vietnam (5) Sex (as stated on originalbirth certificate): E Male E Female (6) Current residence address (street, city, county, and zip code): 2455 Amaryl Dr, San Josel Santa Clara County, 95132 c. Reason for name change (explain): | have gone by Tien Thi Thuy Nguyen by entire life, and recently discovered that my naturalization certificate and social security has a MFQCQNC Gum d. Relationship of the petitionerto the person whose name wiH be changed: (1) E self (4) E nearrelative (indicate reiationship): (2) E parent (5) E Other(speclfy): (3) E 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: (1) 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 ldeclare under penalty of perjury under the laws of the State 0f Caiifomia that (check one) El | am not E l am under the jurisdiction of the Ca1ifomia Department of Corrections and Rehabilitation (in state prison or on parole) or in county jail and (check one) E l am not E I am required to register as a sex offender under Penal Code section 290. Date: 3131121 Thuy Tien Thi Nguyen ' (TYPE 0R PRINT NAME 0F PERSON WHOSE NAME Is 'ro BE CHANGED) (SIGNATURE or: P5R§0N WHOSE CHANGED) (lfpefitloner is represented by an attorney, the attorney's signature follows): Date: mp5 0R PRINT NAME) ‘ (SIGNATURE 0F ATrORNEY) (Each petitionermust slgn 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 ofthe State of California that the information in the foregoing petition is true and correct. Date: 3/31/21 Thuy Tien Thi Nguyen ’ q/lKW UYPE 0R PRINT NAME) (HWONER) Date: ‘ ‘ (TYPE 0R PRINT NAME) (SIGNATURE 0F PETITIONER)E ADD ADDITIONAL SENATURE LINES FOR ADDITIONAL PETITIONERS SIGNATURE 0F PETFTIONERS FOLLOWS LAST ATTACHMENT page 1 0'1 Form Adopted fur Mandatory Use A'rrACHMENT To Coda o! CM] Procedure, § 1275 el seq‘ Judicial Council of California www.wurficagov Nc-11o [Rem September 1. 201a] PETITION FOR CHANGE 0F NAME For your protection and privacy, please press [he Clear Thls Form button after you have printed the form. Ffifint thfg'fo‘r'Ffiml I save this form Eiear t'fi'fs-form