JDF 422 – Notice to Non-Custodial Parent (Minor Name Change) R:11/20 Page 1 of 1
qCounty Court qDistrict Court qDenver Juvenile Court
________________________________ County, Colorado
Court Address:
In the Matter of the Petition of:
Parent/Petitioner: for
Minor Child:
to Change the Child’s Name to:
Attorney or Party Without Attorney (Name and Address):
Phone Number: E-mail:
FAX Number: Atty. Reg. #:
Case Number:
Division Courtroom
NOTICE TO NON-CUSTODIAL PARENT
Notice to: , non-custodial parent.
Notice is given that a hearing is scheduled as follows:
Date: _____________________________________________
Time: _____________________________________________
Location: _____________________________________________
_____________________________________________
for the purpose of requesting a change of name for
_________________________ ___________________________ ___________________________.
First Name Middle Name Last Name
At this hearing, the court may enter an order changing the name of the minor child.
You may attend the hearing and participate or voice objection to the proposed change of name.
Date: __________________________ _____________________________________________
Signature of Parent/Petitioner
____________________________________________
Address
_____________________________________________
City, State, Zip Code
_____________________________________________
Telephone #: (home) (work) (cell)
CERTIFICATE OF MAILING
I certify that on ____________________________ (date), I placed in the United States mail, certified and postage
prepaid, a copy of this Notice addressed to the Non-custodial Parent:
Name: __________________________________
Address: ________________________________
City/State/Zip Code: _______________________
____________________________________________
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