1. My current address is , , Illinois, .
2. My occupation and amount of public benefits is: , .
3. My other sources of income or support are: None.., .None.
7. I own no real estate. The total value of all my personal property does not exceed in value and consists of clothing and furniture, and other household items, including a , motor vehicle, valued at .
STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT
COUNTY
)
| |
| ) | No. ____________________ |
)
)
MOTION TO WAIVE PUBLICATION COSTS
I, state the following facts are true:
1. I have filed an Application to Sue as a Poor Person, which lists my income, resources and assets.
2. An order was entered by this Court that allowed me to pursue this action without payment of costs.
3. Illinois case law recognizes that publication costs of persons like myself are a local obligation and that service by publication is a constitutional right under due process of law. King v. King, 21 Ill. App.3d 1062, 316 N.E.2d 555 (4th Dist. 1974).
WHEREFORE, I ask that the Court waive publication costs and order the County Treasurer to pay the costs of publication to the newspaper which publishes the required Notice of Filing of Petition For Change of Name.
______________________________, Plaintiff
Under penalties as provided by law pursuant to Section 5/1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters therein stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that she/he verily believes the same to be true.
______________________________, Plaintiff
STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT
COUNTY
)
| |
| ) | No. ____________________ |
)
)
ORDER WAIVING PUBLICATION COSTS
The Court, having considered the Motion to Waive Publication Costs filed herein by Plaintiff and having previously allowed Plaintiff to pursue this action as a poor person, finds that Plaintiff is indigent.
IT IS HEREBY ORDERED that the Clerk of the Circuit Court shall cause publication to be made on behalf of Plaintiff and the Treasurer of County pay costs of publication upon presentation of a statement by the newspaper wherein such notice was published and upon filing and allowance of claim. The County Treasurer shall pay for such necessary and proper expenses pursuant to 55 ILCS 5/ 5-1106.
|
DATE:___________________ | ENTER:___________________________________ |
JUDGE
STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT
COUNTY
)
| |
| ) | No. ____________________ |
)
)
NOTICE OF FILING OF PETITION FOR CHANGE OF NAME
Notice is given you, the public, that on , I will file a Petition For Change of Name in this Court asking the Court to change my present name of to the name of .
|
DATE_____________________________ | PLAINTIFF_____________________________ |
STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT
COUNTY
)
| |
| ) | No. ____________________ |
)
)
PETITION FOR CHANGE OF NAME
I, , without the assistance of an attorney, ask this Court to change my name. In support of my Petition, I state the following items are true:
|
1. | This Court has jurisdiction over the subject matter and myself |
|
3. | My current address is: , , Illinois . |
|
4. | I have lived in Illinois for at least 6 consecutive months before I filed this Petition. |
|
6. | My current full name is: . |
|
7. | The new name I would like the court to give me is: . |
WHEREFORE, I request that the Court grant my Petition For A Name Change.
______________________________, Plaintiff
Under penalties as provided by law pursuant to Section 5/1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters therein stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that she/he verily believes the same to be true.
_____________________________, Plaintiff
STATE OF ILLINOIS
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT
COUNTY
)
| |
| ) | No. ____________________ |
)
)
ORDER FOR CHANGE OF NAME
The Court, having considered the Petition for Change of Name filed herein by Plaintiff, heard the evidence, and being otherwise fully advised in the premises, finds that it should be granted.
IT IS HEREBY ORDERED that the Plaintiff's name of , is hereby changed to: , by which he shall be hereafter known and called.
|
DATE: ___________________________ | ENTER:___________________________________ |
JUDGE
LETTER TO NEWSPAPER
DATE: ____________________
Newspaper
, Illinois
Dear Sir or Madam:
Re: , Case number: ______________
Enclosed you will find a Notice to File Petition For Change of Name in the above referenced case. Please run this Notice once a week for 3 weeks. After publication has been completed, please send the Certificate of Publication to me in the enclosed self addressed stamped envelope.
( ) Please bill me for the cost of publication. If you have any questions, please feel free to contact me.
( ) Please bill the office of the Treasurer in __________________ County,
___________________ County Courthouse, _________________________, Illinois for the cost of publication. I have enclosed a court order requiring the Treasurer to pay the cost of publication in my case. If you have any questions, please feel free to contact me.
I thank you for your cooperation.
Sincerely,
, Illinois