Public Notice State of Indiana County of Jay, SS In the Jay Circuit Court Case No. 38C01-1405-MI-12 In Re: the Name Change of: Alisha Lee Ann Grider Petitioner Verified Petition for Change of Name Petitioner, Alisha Lee Ann Grider, Pro Se respectfully petitions this court to change her name. In support of this Petition, Petitioner states as follows: That my current name is: Alisha Lee Ann Grider The following is a list of all my previous names: None 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. That the following judgements of criminal conviction of felony under the laws 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 have no felony convictions. That I am not seeking to defraud creditors by changing my name. That I have published notice of my request for name change in a local publication as required by law, and will bring proof of publication to the hearing. That I am not a sex or violent offender who is required to register under I.C. 11-8-8 That pursuant to Indiana Code 34-28-2-1, I wish to change my name. The reason I want to change my name is: I wish to take my mother and stepfather's last name. That I wish to change my name to Alisha Lee Ann Byers. 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. Alisha Grider CR 5-24,31,6-7-2014 -HSPAXLP