____________ DISTRICT COURT, ______________________ COUNTY, UTAH 

OURT’S ADDRESS:  _____________________________________________________ 

 

N THE MATTER OF THE   
NAME CHANGE OF: 

_____________________________,. 
(minor’s name) 

    PETITIONER’S AFFIDAVIT 
     IN SUPPORT OF MOTION 
     TO WAIVE SERVICE 
      

         A minor. 
 

Case No. ____________________ 

Judge  _______________________ 

 

  C

 

   I

  _

     

 

   

etitioner states as follows: 

in this matter because: 

1.  I ask that the Court not require service of the Summons and Petition for Name Change 

_______________________________________________________________________ 

_______________________________________________________________________ 

_______________________________________________________________________ 

_______________________________________________________________________ 

_______________________________________________________________________ 

  P

 

Minor’s Name Change:  Affidavit in Support of Motion to Waive Service, p. 1        Approved:  November 19, 2004 
 

_____________________________ 
(Name) 
_____________________________  
(Address) 
_____________________________  
(City) 
_____________________________  
(Telephone) 

   

NOTARY CLAUSE 

DATED:   _________________________ 

 

____________________________________ 
Petitioner 

__________________________, Petitioner, is personally known to me or presented  
 
satisfactory proof of identity to me. After being sworn and while under oath, Petitioner stated 
that he or she was acting voluntarily, had read and understood the preceding document, and that 
the contents were true. Petitioner then signed the document in my presence.   

igned on _________________, 20____.    X_________________________________________ 

     Notary Public/Court clerk 

Notary Seal) 

  (

 

 

 

 

 

 

 

 

 

 

 

 

 

    S

 

     

 

Minor’s Name Change:  Affidavit in Support of Motion to Waive Service, p. 2        Approved:  November 19, 2004