Name Change, Jacqueline Toppe

Verified Petition For
Change of Name

State of Indiana

SS:

County of Jackson

In Re the Name Chanage of: Jacqueline A. Toppe

In the Jackson Circuit Court

Case No. 36C01-0808-MI-42

Petitioner, Jacqueline Arlene Toppe, pro se, respectfully petitions this Court to change her name. In support of this Petition, Petitioner states as follows:

1. That my current name is: Jacqueline Arlene Toppe.

2. That I reside at: 436 Redwood Dr., Seymour, Indiana.

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 wish to change my name to: Jacqueline Arlene Scott.

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.

Jacqueline Arlene Toppe

436 Redwood Dr.

Seymour, IN 47274

812-522-3432

S 4, 11, 18