STATE OF INDIANA
COUNTY OF KOSCIUSKO )
CAUSE NO. 43C01-2407-MI-72
IN RE THE NAME CHANGE OF:
Carter Ciaccia
Petitioner
VERIFIED PETITION FOR CHANGE OF NAME
Petitioner, Carter Ciaccia, pro se, respectfully petitions the court to change name. In support of this Petition, Petitioner states as follows:
1. That my current name is Carter Lee Ciaccia.
2. That my date of birth is January 12, 2007.
4. That my mailing address is: 207 N. East Street, Milford, IN 46542.
6. That I do not hold a valid United States passport. My proof that I am a United States citizen is birth certificate. I will bring this document to my change of name hearing for verification.
7. That the following judgements of criminal conviction of a felony under the law of any state or the United States have been entered against me, or I have stated immediately below that I have no felony convictions: I do not have any felony convictions.
8. That I am not seeking to defraud creditors by changing my name.
9. That I have published notice of my request for change of name in a local publication as required by law, and will bring proof of publication to the hearing.
10. That I am not a sex or violent offender who is required to register under Indiana Code 11-8-8.
11. That I wish to change my name to: Carter Lee Coday.
12. That I request that the name on my birth certificate be changed to my new changed name. Specifically, Carter Lee Coday.
WHEREFORE, I respectfully request that this Court grant my Petition for Name Change, and for all other just and proper relief. I affirm under penalties for perjury that the foregoing representations are true.
Carter Ciaccia
207 N. East Street, Milford, IN 46542
STATE OF INDIANA
COUNTY OF KOSCIUSKO )
Before me, Patricia Gall, a notary republic, Kosciusko County, State of Indiana, personally appeared Carter Lee Ciaccia, and being first duly sworn upon his/her oath, says that the facts alleged in the foregoing instrument are true.
Date: 7/2/2024
Patricia Gall, Notary Republic
My Commission Expires: 4/27/2031