NOTICE OF PETITION FOR CHANGE OF NAME STATE OF INDIANA SS COUNTY OF KOSCIUSKO IN RE THE NAME CHANGE OF: AMY BETH STAFFORD, Petitioner IN THE KOSCIUSKO CIRCUIT COURT CASE NO. 43C01-1512-MI-284 Amy Beth Stafford, whose mailing address is: 3312S. Country Club Rd., Warsaw, IN 46580, And, if different, my residence address is: Kosciusko County, Indiana hereby gives notice that she has filed a petition in the Kosciusko Circuit Court requesting that her name be changed to Amy Beth Black. Notice is further given that hearing will be held on said Petition on the 29th day of January, 2016 at 8:30 o'clock a.m. Any interested person wishing to be heard may appear at the hearing and file written objections to this request. Amy Beth Stafford, Petitioner Date: 12-10-15 Ann Torpy, Clerk of Kosciusko Circuit Court 12-14,21,28 hspaxlp