The Ohio PRB-NC-ACNM form is an application used in the Probate Court of Ashtabula County, Ohio, for requesting a change of name for a minor. This form requires the applicant to be a parent, legal guardian, or guardian ad litem of the minor and to demonstrate that the minor has resided in Ashtabula County for at least one year. Proper documentation, including a certified copy of the minor’s birth certificate, must accompany the application.
The Ohio PRB-NC-ACNM form serves as a crucial document for parents or legal guardians seeking to change the name of a minor in Ashtabula County. This application outlines the necessary steps and requirements for initiating the name change process. It begins by confirming the applicant's relationship to the minor, whether as a parent, legal guardian, or guardian ad litem, and asserts that the minor has resided in Ashtabula County for at least one year prior to filing. A certified copy of the minor’s birth certificate must accompany the application. The form also requires the applicant to provide the names and addresses of both parents or, in cases where the father is unknown, to state that fact clearly. Additionally, the applicant must specify the desired new name for the minor and provide a reason for the change. To ensure transparency, the applicant is responsible for publishing a notice of the application in a local newspaper and notifying any non-consenting parents by certified mail if their addresses are known. The form concludes with a journal entry from the Probate Judge, setting a hearing date and confirming that notice requirements must be met before the hearing can proceed.
PRB-NC-ACNM (REV. 8/10)
PROBATE COURT OF ASHTABULA COUNTY, OHIO
IN RE: CHANGE OF NAME OF
(Present Name)
To
(Name Requested)
Case No.
APPLICATION FOR CHANGE OF NAME OF MINOR
[R.C. 2717.01]
The applicant states that the applicant is the
parent
legal guardian
guardian ad litem of the minor
and that the minor has been a bona fide resident of Ashtabula County, Ohio, for at least one year immediately prior to the filing of this application. A certified copy of the minor’s birth certificate is attached.
The applicant states that the name and address of the mother of the minor is:
Name
Address
City
State
Zip
and the name and address of the father or alleged father of the minor is:
Applicant states that the address of the
mother
father or alleged father is unknown and cannot
with reasonable diligence be ascertained.
There is no person alleged to be the father of said minor.
The applicant requests a change of name of the minor from
to
for the following reason:
FORM 21.2 - APPLICATION FOR CHANGE OF NAME OF MINOR
11/1/00
Page 1 of 2
The applicant states that the applicant will cause notice of the application to be published once in a newspaper of general circulation in this county at least thirty (30) days before the hearing on this application. In addition, notice will be given by the applicant to any non-consenting parent or alleged father, whose addresses are known, by certified mail, return receipt requested.
____________________________________________
Attorney for Applicant
Applicant’s Signature
Typed or Printed Name
Telephone number (including area code)
Attorney Registration No.
JOURNAL ENTRY SETTING HEARING AND ORDERING NOTICE
The Court orders this application set for hearing on the day of, 20 at
The applicant is ordered to cause notice of application to be given by one publication in a newspaper of general
circulation in this county at least thirty (30) days prior to the hearing date, as well as certified mail service, return receipt requested, if necessary, as required by law.
Charles G. Hague, Probate Judge
By: ____________________________________________
Deputy Clerk
Page 2 of 2
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