STATE OF INDIANA VIGO CIRCUIT COURT IN RE THE CHANGE OF NAME OF MINOR: Mackenzie Alise Wood JARED A. TURNER, Petitioner. CAUSE NO. 84C01-1609-MI-6482 VERIFIED PETITION FOR CHANGE OF NAME OF MINOR Petitioner, Jared Turner, by counsel, respectfully petitions this Court to change the name of Mackenzie Alise Wood ("Mackenzie") and in support states: 1.Petitioner is the natural father of Mackenzie whose name is sought to be changed. 2.Petitioner resides at 2427 Garfield Avenue, Terre Haute, IN 47804. 3.Allison Wood is Mackenzie's natural mother. 4.The written consent of Allison Wood, the non-petitioning parent or guardian, for the name change of the minor child is filed with this Petition. 5.That the child's current name is Mackenzie Alise Wood. 6.That the child's date of birth is June 6, 2003, and a copy of the birth certificate is attached hereto. 7.That the child's mailing address is 2427 Garfield Avenue, Terre Haute, IN 47804. 8.That changing the child's name is not an effort to defraud any of the child's creditors. 9.The child does not have a criminal record. 10.That the child is not confined to a Department of correction facility or a sex or violent offender who is required to register under I.C. 11-8-8. 11.That pursuant to Ind. Code 34-28-2-1, Jared A. Turner petitions this court to change the child's name. Pursuant to Ind. Code 34-28-2-2(b), the reason for the change of the child's name is requested is: Mother is getting married and Mackenzie wants her Father's last name. 12.That Petitioner request that the child's name be changed to Mackenzie Alise Turner. 13.That Allison Wood, non-petitioning parent or guardian of the Minor child, has been served with a copy of this Petition as required by the Indiana Trial Rules. 14.Petitioner requests this Court set a hearing to consider the Petition for Change of Name of Minor Child. WHEREFORE, Petitioner respectfully requests that this Court grant this Petition for Name Change of a Minor, and for all other just and proper relief. Jared A. Turner, Petitioner VERIFICATION I, Jared A. Turner, AFFIRM under the penalties for perjury, that the above and foregoing representations are true to the best of my knowledge. Jared A. Turner, Petitioner 174138 TS 10/12, 10/19, 10/26/16 hspaxlp
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