Free Microsoft Word - NAM207 - Minnesota

State of Minnesota
County
Select County
In the Matter of the Application of:
First Middle Last

District Court
Judicial District: Court File Number: Case Type: Name Change

On Behalf of:
First Middle Last

Affidavit in Support of Order for Publication and Order for Publication (Minor Name Change) (Minn. Stat. § 259.10, subd. 1)

For a Change of Name to:
First Middle Last

STATE OF MINNESOTA

) ) COUNTY OF ____________________ ) (County where Affidavit signed)

ss.

The undersigned applicant has sworn/affirmed on oath and states that: 1. I have filed an Application for Name Change in _________________ County District Court for a change of name for the minor child(ren) from _____________________________________________________ to __________________________________________________________________________________. A Notice of Hearing and copy of the Application for Name Change was mailed to the non-applicant parent at his or her last known address and was returned. An attempt at personal service of the Notice of Hearing and Application for Name Change was unsuccessful. I do not know the address of the non-applicant parent. The last known location of the non-applicant parent was: . 4. The last known location of the non-applicant parent's employment was: . 5. The names and addresses of the non-applicant parent's parents, brothers or sisters, children, and other close relatives are: _____________________________________________________________________ . 6. I have made the following efforts to get the non-applicant parent's address from these persons: .

2a. 2b. 2c. 3.

NAM207

State

ENG

Rev 8/08

www.mncourts.gov/forms

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Therefore, I request that the Court allow publication of the Notice of Hearing. I further request that the Court set a new hearing date, if necessary.

Subscribed and sworn to before me Date: Applicant Deputy Court Administrator/Notary Public Order for Publication Based on the above Affidavit, IT IS ORDERED: 1. Notice shall be given by publication once a week for three consecutive weeks in the legal newspaper of the county of the other parent's last known address. 2. The date and time of the Hearing on the Application for Name Change is , at .m. at the following address: . 3. Applicant's request for publication is denied.

Dated: Judge of District Court

NAM207

State

ENG

Rev 8/08

www.mncourts.gov/forms

Page 2 of 2