Petition Name Change

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

NC-1 00 AWORNEY 0R PARTY wm-IOUT ATTORNEY STATE BAR NUMBER; NAME; Michael Kifle Tesfay FIRM NAME: STREET ADDREss; 808 West San Carlos Skeet Apt. 392 cmr;8an Jose STATE: CA ZIP CODE: 95126 TELEPHONE N04{405) 794‘5339 FAX N0; E-MNL ADpRESS: ' ATTORNEY FOR (name): Self‘Represented SUPERIOR COURT 0F CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS: 191 Nonh First Street MAILING ADDRESS: SAME CITY AND le CODE: san JOSE, 951. 13 BRANCH NAME: Downtown Superior Court PETITION OF (name of each petitioner): Michael Kifle Tesfay F%LEI APR U 1 2021 PETITION FOR CHANGE OF NAME CASngERC V3 7 8 9 8 1 county whete the person whose name is to be changed resides. Before you complete this petition, you should read the Instructions far Filing a Petition for Change of Name (form NC-1 00-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. Petitioner (present name): Michael Kifle Tesfay resides in this county. 2. Petitioner requests that the Court decree the following name changes (list every name that you are seeking to change): P[esent name Emgosed name a. Michael Kine Tesfay changed to Abraham Kine Tesfay b. changed to c. ‘ changed t0 d. ; changed t0 E Continued ‘(ifyou are seeking to change additional names, you must prepare a list and attach it to this petition as Aflachmenf 2.) 3. Petitioner requeéts that the court issue an order directing all interested persons to appear or file objections to show cause why this petition for cpange 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 is (specify): 5. lf this petition requests the change of name of any person or persons under 18 years, this request is being made by a. D two parents. . E one parent. - E near relative (name and relationship): . E guardian (name):D other(specify): 6. E This petition seeks to change name of (check one) D petitioner to conform to that person's gender identity‘ 90.00- m (name): 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 to Be Changed (form NC-1 1 0) for each person identified in item 2): a. The number of attachments included in this petition is (specify number): b-f. (These are the items on the attached page or pages ofform NC-1 10.) Page 1 of 1 Form Adopted {or Mandatory Use PETITION FOR CHANGE 0F NAME Code of Civll Procedure,§ 1275 e1 seq. Judicial Council of Califomla www.courts.ca.gov Nc-wo [Rem Sepxembemgms] (Change of Name) x I : ’ Nc-11o PETITION OF (Name ofpétitioner orperitioners): CASE NUMBER- Michael Kifle Tesfay FOR CHANGE OF NAME NAME AND INFORMATION ABOUT THE PERSON WHOSE NAME IS TO BE CHANGED Attachment of Attachment to Petition (form NC-1 00, form NC-200, or form NC-SOD) {You must use a separate attachment for each person whose name is (o be changed. pretitioner is a guardian of a minor, a suppfemental attachment, Declaration of Guardian (form NC-1 TOG), must also be compieted and attached for each minor whose name is to be changed.) , 7. (Continued) Petitioner applies for a decree to change the name 0f the foltowing person: b E Self m Other Present name (specihy) Michael Kifle Tesfay (2) V Proposed name (specify): Abraham Kifle Tesfay (3) Born on (déte ofbinh): 10/05/1984 and presently E under 18 years of age E over 18 years of age (4) Born at (place of birth): Addis Abeba, Ethiopia (5) Sex (es stated on original birth certificate): - Male E Female (6) Current reéidence address (street, city, county, and zip code): I 808 West San Carlos Street Apt. 392, San Jose. County of Santa Clara, 95126 c. Reason for name change (explaing: The proposed name fits me better; herefore | would like to be known by this name in all my personal and business affairs. d. Relationship of>the petitioner to the person whose name will be changed: (1) m self‘ (4) D near relative (indicate relationship): ) E pag‘ent (5) D Other (specify): (3) E guardian e. [f the person whose name will be changed Is under 18 years of age, provide the names and addresses if known ofthe following persons: (1) Parent (name): (address): (2) Parent (name): (address): (3) (Onlyif ngither parentis living) Near re1atives (names, relationships, and addresses): < f. lfthe person whose name wi1| be changed is 18 years of age 0r older, that person must sign the following declaration: ‘ DECLARATION | declare under penalty of perjury under the laws ofthe State of California that (check one) i am not E | am underthe jurisdiction of the California Department of Corrections and Rehabititation (in state prison or on parole) or in county jail and (check qne) I am not D | am required to register as a sex offender under Penal Code section 290. Date: 0V/0H 21/ Michael Kifle Tesféy ’ W‘[W (TYPE OR PRINT NAME OF PERSON WHOSE NAME IS T0 BE CHANGED) ,(SIGNATURE OF PERSON WHOSE NAME IS TO BE CHANGED) (lfpetr‘tioner is represented by an attorney, the attorney's signature foilows): Date: > mp5 0R PRINT MAME) (sleNATURE 0F ATTORNEY) (Each petitioner mils! sign this petition in the space provided below or, if additional pages 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 correct. Date: 09/0); Q.) Michael Kine Tesfay‘ } I‘m” [A /\ /'\ ‘ (TYPE 0R PRlNT NAME) ' (snbflATuMoF PEW'NER) Date: b (TYPE 0R PRINT NAME) (SIGNATURE 0F PETmONER) [_-| ADD ADDITIONAL SIGNATURE LINES FOR ADDITIONAL PETITIONERS |-'| SIGNATURE 0F PETITIONERS FOLLOWS LAST ATTACHMENT Page 1 o“ Form Adopted tor Mandatory Use ATTACHMENT T0 Code of Civil Procedure, § 1275 el seq. Judicial Council of Callfo mia ww.couds.ca.gov Nommev.SeptemberLzmsl PETITION FOR CHANGE OF NAME