Order Change of Gender Issuance of New Birth Certificate

Cal. Super. - 6th Dist.April 2, 2021

NC-230 ATTORNEY on PARTY wn'Hour ATTORNEY srATE BAR NUMBER- Fon counrUSEaNLv NAME: Ellery Susan Carlson FIRM NAME: smear ADDRESS; 5637 Calmor Ave. #2 crrY: San Jose STATE CA ZIP oops: 95 1 23 TaEPHONE N0.: (408) 375-7962 FAX N0.: E.MAILADDREss- ellerycarlson7@gmail.com manna ma (name): Self-Represented SUPERIOR coum 0F GAuronNIA, COUNTY 0F Santa Clara smser ADDRESS: 191 N. First street MAILING ADDRESS: 1 91 N. First Street cm AND ZIP cons:san Jose, CA 951 13 BHANCH NAME CW" DiViSiOI'I PETITION OF (name ofpetil’ioner): Ellery Susan Carlson FOR CHANGE OF NAME AND GENDER DEGREE CHANGING NAME AND ORDER RECOGNIZING CHANGE OF CASE Numgfl c V 3 7' 9 G 3 3GENDER AND FOR ISSUANCE OF NEW BIRTH CERTIFICATE 1. The petition was duly considered: a. D atthe hearing on (date): (0 I1 I 3°; fl in Courtroom: ofthe above-entitled court. b. D without hearing. THE COURT FINDS 2. a. All notices required by law have been given. b. Each person whose name is to be changed identified in item 3 belowm is not D is required to register as a sex offender under section 290 of the Penal Code. This determination was made m by using CLEI'S/CJIS D based on information provided to the clerk of the court by a local law enforcement agency.m No objections to the proposed change of name were made.D Objections to the proposed change of name were made by (name): e. It appears to the satisfaction of the court that all the allegafions in the petition are true and sufficient and that the petition should be granted. f. D Other findings (if any): 9-.“ THE COURT ORDERS 3. The name of (present name): Ellery Susan Carlson is changed to (new name): Ellery Nolan Carlson THE COURT FURTHER ORDERS 4. The gender of (new name): Ellery Nolan Carlson is changed to: a. D female. b. m male. c. D nonbinary. THE COURT FURTHER ORDERS 5. A new birth certificate shall be issued reflecting the changes in name andlgender. 6. If petitioner was born In California, a certified copy of this order shall be filed by petitioner within 30 days with the State Registrar. When the State Registrar receives a certified copy of this order and payment of the applicable fees, the State Registrar shall establish for the petitioner a new birth certificate reflecting the new name and the gender of the petitioner as it has been altered. Date: JUDGE OFTHE SUPERIOR ooumD SIGNATURE 0FJUDGE FOLLows LAST MTACHMENT P8531011 fwdgdémflimgm DEGREE CHANGING NAME AND ORDER HECOGNIZING CHANGE Codedcwn Procedure, §§ 1273,0155? nonmemsemammzma] 0F GENDER AND Fon ISSUANCE 0F NEW BIRTH CERTIFICATE ””“h‘s°'°”°°“'§§ ”“3“” CEB' Essential um". Em Signed: 7/19/2021 09:08 AM July 19, 2021 X Filed July 21, 2021 County of Santa Clara Superior Court of CA Clerk of the Court 21CV379033 By: tngo JULIE A EMEDE