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In the General Court of Justice
STATE OF NORTH CAROLINA Superic+r Court Oiviaion
County of ~~Z~r Before The Clerk
In the Matter of the Change of NaN~e ORDER AND CERTIFICATE
OF ~1~~ r~tiMll Of NAME CHANGE
TO ~,~111Ml~ IIN1~
IT APPEARING to the aatisfgction of the Court fraw the application in the Nutter naiNed above that
good and sufficient reason exists for the change of naae. that the party is entitled and not in any
way disqualified to have his naiNe changed. and that the provisions o G.S. Chapter 101 have been
caNpl ied with;
AND IT FURTHER APPEARING that the following inforNiation appears on the birth certificate of the
party whose nave is to be changed:
S~L* >~rla~~ Iflw~~ ••i~~i _!lt3~!/!s ?l~el~M
Full Naae at Blrtt, Date or atrtA NlrtAplaee-. County and Stata
t1~Nt MM1~ AtiaN •ftN~n
Full Naae of FatAer Full Yaldea Naga or Yotsar
IT IS. THEREFORE. ORDERED AND ADJUDGED that the naiNe of the party be changed from ,NSl~
~ylvat~s vim ~ ara~r ~rlw~l~s N~Mt~ ~ • .
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In Mitness Mhereof, 1 have hereunto set ay .hand and affixed..ths'Seal ot~ Superior Court. this
the day of ~11~! ~ 19 ~ • - , ~ ~ • ~ ~
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Address M~~~ `:1~~`=~ J3,~~• •
G. S. Ch. 101 { •
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AOC-L Porgy 301
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