Petition Name Change

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

.4(:- 'L .gq'rz. f 3 ,. “.31" {ft m ma" - NC-100 ArrORNEY 0R PARTY WITHOUT ATTORNEY STATE EAL; QUMEEign NAME: Rafael Melendez Puente g“ FIRM NAME: STREETADDRESS: 9101 Wren Ave \ PR cm: Gilroy STATE; Cfilm ificooz; TELEPHONE No; (408) 464-9977 FAX N0; I E.MAILADDRESS: ' _ AUORNEV Fomname); In Pro Per ’ " - . ‘ 5 SUPERIOR COURT OF CALIFORNIA, COUNTY 0F SANTA CLARA STREETADDRESS: 191 North First Street MAILING ADDRESS: 191 North First Street cmrANDZIP CODE: San Jose. CA 951 1 3 BRANCH NAME: Probate Q 2 iii 71,»- PETITION OF (name of each petitioner): Rafael Melendez Puente PETITION FOR CHANGE 0F NAME CASE NUMBER: F%a0vavsése county where the person whose name is to be changed resides. Before you complete this petition, you should read the Instructions for Filing a Petition for Change ofName (form NC-1 004NFO). You must answer all questions and check all boxes that apply to you on thls petition. You must file this petition in the superior court of the 1. Petitioner (presentname): Rafael Melendez Puente 2. Petitioner requests that the court decree the following name changes (list every name that you are seeking to change): Pregem name Proposed name a. First: RAFAEL‘ Last: MELENDEZ PUENTE changed to First: RAFAEL. Middle: PUENTE. Last MELENDEZ b. changed to c. changed to d. changed to E 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 5. lfthis petition requests the change of name of any person or persons under 18 years, this request is being made by a. E two parents. b. E one parent. C- E near relative (name and relationship): d. E guardian (name): 9- E other(speci:y): 6. E This petition seeks to change name of (check one) E petitioner D. (name),- to conform to that person's gender identity. 7. For each person whose name is to be changed, petitioner provides the following information (you must attach a compieted copy of the attachment Name and Information About the Person Whose Name ls to Be Changed (form NC-110) for each person identifiegj in item 2): a. The number of attachments included in this petition is (specify number): 1 b-f. (These are the items on the attached page orpages of fonn NC-1 10.) FMAW‘W“”mam ”5° PETITION FOR CHANGE OF NAME Judidafl Council o! California NC-1mlRev. Semember 1.2018] (Change of Name) resides in this county. Pagm 011 Code MGM Procedm'e. § 1275 e 5qu www.wUnSLJQOV NC-11 D PETITION OF (Name ofpetitioner or petitioners): Rafael Melendez Puente CASE NUMBER; FORCHANGEOFNAME “gig C V30? 89 8 6 NAME AND INFORMATION ABOUT THE PERSON WHOSE NAME IS T0 BE CHANGED Attachment 1 of 1 Attachment to Petition (form NC-100, form NC-ZOO, or form NC-SOD) (You must use a separate attachment for each person whose name is t0 be changed. lfpetitioner is 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 (o be changed.) 7. (Continued) Petitioner applies for a decree to change the name of the following person: b. E Self E Other (1) Present name (specifir): First: RAFAEL, Last: MELENDEZ PUENTE (2) Proposed name (specify): First: RAFAEL. Middle: PUENTE, Last: MELENDEZ (3) Born on (date of birth): October 24. 1966 and presently E under 18 years of age m over 18 years of age (4) Born at (place ofbinh): Mexico City, Mexico (5) Sex (as stated on original birth certificate): E Male Cl Female (6) Current residence address (street, city, county, and zip code): 9101 Wren Ave. Gilroy. Santa Clara. 95020 c. Reason for name change (explain): l have two last names with no hyphen and it is confusing because people think my second last name is my only last name. Iwant to make my second last name my middle name and leavejust my first last name as my only last name. d. Relationship of the petitioner to the person whose name will be changed: (1) :3 self (4) E near relative (indicate relationship): (2) i: parent (5) E Other (specify): (3) E guardian e. lfthe 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) (Onlyifneftherparentis living) Near relatives (names, relationships, and addresses): f. Ifthe person whose name will be changed is 18 years of age or older, that person must sign the following declaration: DECLARATION l deciare under penalty of perjury underthe laws ofthe State of California that (check one) El | am not D | am under the jurisdiction 0f the California Department of Corrections and Rehabiiitation (in state prison or on parole) or in county jail and (check one) E | am not E | am required t0 register as a sex offender under Penal Code section 290. Date: March 3o, 2021 > m q k fl aE k A Rafael Melendez Puente awe 0R pRINT NAME 0F PERSON WHOSE NAME 13 To BE CHANGED) l (SIWRE ofiensbu WHOSE NAME Is To BE CHANGED) I (pretitioner is represented by an attorney, the attomey’s signature follows): Date: b mp5 0R PRINT NAME) (SIGNATURE 0F ATTORNEY) {Each petitioner must sign this petition in the space provided below or, if additional pages are attached, at the end of the Ias‘ attachment.) l declare under penalty of perjury under the laws of the State of California that the information in the foregoing petition [ true and correct F H U) Date: March 30, 2021 Rafael Melendez Puente } (TYPE OR PRINT NAME) GNATUR OF PETITIONER) Date: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) I I ADD ADDITIONAL SIGNATURE LINES FOR ADDITIONAL PETITIONERS SIGNATURE OF FETlTIONERS FOLLOWS LAST ATTACHMENT page 1 0'1 Farn Adopted for Mandatory Use ATTACHMENT To Code of Cim] Procedure. § 1275 e seq. www.moourrscagov fififiifligtfliflimm PETITION FOR CHANGE 0F NAME