STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
PUBLICATION OF NOTICE OF
HEARING FOR NAME CHANGE
CASE NO. and JUDGE
Court address Court telephone no.
Approved, SCAO
Form PC 50, Rev. 7/21
MCL 711.1, MCR 2.106(D), MCR 3.613
Page 1 of 1
In the matter of
Current name of the subject of the petition
TO ALL PERSONS, including: (specify non-custodial parent’s name here, if applicable)
whose address is unknown and whose interest in the matter may be barred or affected by the following:
TAKE NOTICE: A hearing will be held on
Date and time
at
Location
before Judge
to change the name of:
Current name
to
Proposed name
Current name
to
Proposed name
Current name
to
Proposed name
Current name
to
Proposed name
Current name
to
Proposed name
Current name
to
Proposed name
PUBLISH ABOVE INFORMATION ONLY
Publish
time(s) in
Name of publication
in
County.
Furnish
copies to
.
Furnish affidavit of publication to the court. Petitioner shall file affidavit of publication with the court clerk.
Forward statement for publication charges to
.