Notice of Intention to Resume Prior Surname

Form 15

Divorce Form 15 Notice of Intention to Resume Prior Surname Instructions

Form 15 - Notice of Intention to Resume Prior Surname

The numbers on these instructions correspond with the numbers in the boxes on the form. Use the form with the boxes to guide you through filling out the blank form.

Box 1: Print the name of the county in which you filed exactly as it appears on Form 1.

Box 2: Print the name of the Plaintiff exactly as it appears on Form 1.

Box 3: Print the docket that the Prothonotary's Office wrote on Form 1 at the time of filing.

Box 4: Print the name of the Defendant exactly as it appears on Form 1.

Box 5: Print your current full name.

Box 6: Print either “Plaintiff” or “Defendant.” (If you filed the original Divorce Complaint, then you are the Plaintiff. If you did not file the original Divorce Complaint then you are the Defendant).

Box 7: Check the date the Divorce Complaint was filed or the date a Divorce Decree was granted.

Box 9: Print the date the Divorce Decree was granted.

Box 10: Print the surname (last name) of the name you wish to resume.

Box 11: Print the date you sign the document.

Box 12: Sign your current name.

Box 13: Sign the name you are resuming.

Box 14: Write your spouse's name by arrowbox 3. Write your spouse's name exactly as you wrote it on Form 1, by arrowbox 3.

IF YOUR COUNTY REQUIRES THIS FORM BE NOTARIZED, DO NOT SIGN THIS FORM UNTIL YOU ARE IN FRONT OF A NOTARY PUBLIC.

Box 8: Print the date the Divorce Complaint was filed.

Box 14: Print the name of the county you are filing in exactly as you wrote in on Form 1.

Box 15: Print your name exactly as you wrote it on Form 1.

OR

Divorce Form 15 Notice of Intention to Resume Prior Surname Instructions

Box 16: Print the docket number. The docket number is the number that the Prothonotary's Office wrote on Form 1, at the time of filing.

Box 17: Print your spouse's name exactly as you wrote in on Form 1.

The Notary Public will complete the rest of this form.

Divorce Form 15 Notice of Intention to Resume Prior Surname Instructions

1

IN THE COURT OF COMMON PLEAS OF COUNTY, PENNSYLVANIA CIVIL ACTION

2

, :

PLAINTIFF : 3 : : Case No.

4 vs. : :

, : DEFENDANT : IN DIVORCE

NOTICE OF INTENTION TO RESUME PRIOR SURNAME Pursuant to Title 54 P.S. 704

5

NOTICE is hereby given that I, ,

the (Plaintiff or Defendant) in the above-

captioned case in which a:

, orComplaint in Divorce was filed on:

.

10hereby elect to resume the prior surname of

11Date:

12

Signature using your current name

13

Signature using name being resumed

6

7 8

9Decree in Divorce was filed on:

7

Divorce Form 15 Notice of Intention to Resume Prior Surname Instructions

14IN THE COURT OF COMMON PLEAS OF_ COUNTY, PENNSYLVANIA

, :

PLAINTIFF : 16: : Case No.

vs. : :

, : DEFENDANT : IN DIVORCE

COMMONWEALTH OF PENNSYLVANIA

COUNTY OF

On this, the day of _, 20 ,

personally appeared before me, a Notary Public in and for said Commonwealth

and County, (full married

name), known to me (or satisfactorily proven) to be the person who is the person

whose name is subscribed to the within document and acknowledged that she

executed the same for the purposes therein contained.

Notary Public:

My Commission Expires:

15

17

Divorce Form 15 Notice of Intention to Resume Prior Surname AOPC 7.1.14

IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY, PENNSYLVANIA CIVIL ACTION

_______________________________, : PLAINTIFF :

: : Case No. ______________

vs. : :

_______________________________, : DEFENDANT : IN DIVORCE

NOTICE OF INTENTION TO RESUME PRIOR SURNAME Pursuant to Title 54 P.S. 704

NOTICE is hereby given that I, ________________________________ ,

the __________________________ (Plaintiff or Defendant) in the above-

captioned case in which a:

Complaint in Divorce was filed on: ___________________, or

Decree in Divorce was granted on: ___________________.

hereby elect to resume the prior surname of _____________________________

Date: _________________ ________________________________ Signature using your current name

________________________________ Signature using name being resumed

Divorce Form 15 Notice of Intention to Resume Prior Surname AOPC 7.1.14

IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY, PENNSYLVANIA

_______________________________, :

PLAINTIFF ::: Case No. ______________

vs. : :

_______________________________, : DEFENDANT : IN DIVORCE

COMMONWEALTH OF PENNSYLVANIA

COUNTY OF ________________________

On this, the _______ day of ___________________________, 20_____,

personally appeared before me, a Notary Public in and for said Commonwealth

and County, ________________________________________ (full married

name), known to me (or satisfactorily proven) to be the person who is the person

whose name is subscribed to the within document and acknowledged that she

executed the same for the purposes therein contained.

Notary Public:

My Commission Expires: