NOTICE OF PETITION FOR CHANGE OF NAME STATE OF INDIANA SS COUNTY OF KOSCIUSKO IN RE THE NAME CHANGE OF BELINDA J. KOUKABE, Petitioner IN THE KOSCIUSKO CIRCUIT COURT CASE NO. 43C01-1506-MI-130 Belinda J. Koukabe, whose mailing address is: 505 Hitzler St., Warsaw, IN 46580. And, if different, my residence address is: Same, Kosciusko County, Indiana hereby gives notice that she/he has filed a petition in the Kosciusko Circuit Court requesting that his/her name be changed to Belinda Jane Hollar. Notice is further given that hearing will be held on said Petition on the 7th day of August, 2015, at 8:30 o'clock a.m. Belinda J. Koukabe, Petitioner Date: 6/1/15 Ann Torpy, Kosciusko Circuit Court Clerk 6-5,12,19 hspaxlp