Fillable 600-00846 0 STATE OF VERMONT

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600-00846 0 STATE OF VERMONT

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600-00846 - Notice of Name Change or Change of Address (01/2018) Page 1 of 1
STATE OF VERMONT
SUPERIOR COURT
DIVISION
Unit
Docket No.:
Case Name:
NOTICE OF NAME CHANGE OR CHANGE OF ADDRESS
This is to notify the Court that:
☐ My name has changed:
Former name: _____________________________________________
New name: _____________________________________________
☐ My address, phone number or email address has changed:
Former Address:
Name: __________________________________________________________
Street Address: ________________________________ City/State/Zip: __________________________
Mailing Address (if different from Street Address): ___________________________________________________
City/State/Zip: ________________________________ Email Address: __________________________
Daytime Phone: _______________________________ Evening Phone: _________________________
Attorney Name & Phone Number: ______________________________________________________
New Address:
Name: __________________________________________________________
Street Address: ________________________________ City/State/Zip: __________________________
Mailing Address (if different from Street Address): ___________________________________________________
City/State/Zip: ________________________________ Email Address: __________________________
Daytime Phone: _______________________________ Evening Phone: _________________________
Attorney Name & Phone Number: ________________________________________________________
Dated
_____________________ ____________________________________
Signature
____________________________________
Print Name
NOTE: A Plaintiff in a Relief from Abuse or Stalking Action is not required to complete this form and this
form will not change any bail, probation, or supervised release conditions.
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Completed 3 July 2020

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