Free Consent of Spouse to Name Change and Waiver of Notice - Arizona

Reset
Name of Person Filing: ____________________________________ Mailing Address: ____________________________________ City, State, Zip Code: ____________________________________ Daytime/Evening Phone Number: ____________________________________ ATLAS Number (if applicable) ____________________________________ Attorney Bar Number (if applicable) ____________________________________ Represented by Self or by Attorney

For Clerk's Use Only

SUPERIOR COURT OF ARIZONA MOHAVE COUNTY
In the Matter of ____________________________________ Name of Applicant (Person Requesting Name Change) Case Number:

CONSENT OF SPOUSE TO NAME CHANGE AND WAIVER OF NOTICE

REQUIRED INFORMATION FROM SPOUSE, UNDER OATH OR AFFIRMATION: 1. INFORMATION ABOUT ME:
Name: _____________________________________________________________________________ Address: ___________________________________________________________________________ Telephone: ________________________ Date of Birth: _______________________ ______________________ Month Date I am married to the Applicant (the person requesting the name change). __________________ Year

2.

I have read the Application for Name Change and consent to changing my spouse's LEGAL name to: First: ______________________ Middle: ____________________ Last:________________________

3.

I waive notice of all further proceedings in this matter.

OATH OR AFFIRMATION OF CONSENTING SPOUSE
STATE OF ARIZONA ) COUNTY OF MOHAVE ) ss. The contents of this document are true and correct to the best of my knowledge and belief. Signature: _______________________________________ Date:______________________ Sworn to or affirmed before me on this ______________________ day of _________________, 20__________ By:___________________________________ My Commission Expires: _______________________ _____________________________________ Notary Public or Deputy Clerk

10/14/2006