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Case No. CV-2004-00780

| May 19, 2004 9:00 PM

IN THE DISTRICT COURT OF THE FIRST DISTRICT OF THE STATE OF IDAHO, IN AND FOR THE COUNTY OF

BONNER

IN RE:

Amelia Marie Bloom

Date of Birth: July 21, 1988

A Petition by Amelia Marie Bloom, born on July 21,1988, in the city of Spokane, State of Washington now residing at 23 W. Fry Creek, Sagle, Idaho, proposing a change in name to Amelia Marie Bond has been filed in the above entitled court, the reason for this change in name being that petitioner desires to assume and share the same last name as her mother and step father with whom she lives.

The Petitioner's father is living.

Such petition will be heard at 9:30 o'clock (a. m. on June 21, 2004, in courtroom number ______,at the County Courthouse. Objections may be filed by any person who can, in such objections, show to the court a good reason against such

a change of name.

WITNESS my hand and seal of said District Court this 3 day of May, 2004.

MARIE SCOTT, Clerk of District Court

By Joanna Mollenkops

Clerk

MARGARET R. WILLIAMS

Attorney at Law

P.O. Box 283

Ponderay, Idaho 83852

(208) 263-0555

I.S.B. #4654

Legal SNP#5173

May 6, 13, 20, 27, 2004

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