-
VERIFIED PETITION FOR CHANGE OF NAME STATE OF INDIANA SS: KOSCIUSKO COUNTY IN RE THE NAME CHANGE OF ARCHIE LEE FOXX, JR., PETITIONER IN THE KOSCIUSKO SUPERIOR/CIRCUIT COURT CASE NUMBER 43COI-1011-MI-596 Petitioner, Archie Lee Foxx, Jr., pro se, respectfully petitions this Court to change his/her name. In support of the Petition, Petitioner states as follows: 1. That my current name is: Archie Lee Foxx, Jr. 2. That I reside at: 3290 E. Old Colony Rd., Warsaw, IN 46580. 3. That pursuant to Indiana Code 34-28-2-1, I wish to change my name. 4. That I am not seeking to defraud creditors by changing my name. 5. That I have not been convicted of a felony within the last ten (10) years. 6. That I am not a sex or violent offender who is required to register under IC 11-8-8. 7. That I wish to change my name to: Archie Lee Brownlee. WHEREFORE, I respectfully request that this Court grant my Petition for Name Change, and for all other just and proper relief. I affirm under the penalties of perjury that the foregoing representations are true. Archie Lee Foxx, Jr. 3290 E. Old Colony Road Warsaw, IN 46580 574-377-7925 n5,12,19
