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DECLARATION OF LEGAL NAr1E CHANGE
I, the undersigned, declare that I am 18 years old or older and further dedare:
1. I was bom Courtney Theresa McKeon in the County of New York, State of New
York, USA on June 21, 1967.
2. I hereby declare that I have changed my legal name and will be henceforth
exclusively l:no��m as Iman Courtney Satori, a.k.a. Lnan Satori.
3. My legal name change was completed by order of the Gibson County Circuit
Court, Princeton, Indiana in Cause No. 26C01-O505-MI-0010 on September 8,
2005. A copy of the court order is attached to this declaration.
4. Notice is hereby given to all agencies of the State of Indiana, all agencies of the
Federal government, all creditors, and all private persons, groups, businesses,
corporations, and associations of said legal name change.
>. Please revise all relevant records accordinely.
I declare under penaity of perjuq� under the la�vs of the State of Indiana that the
foregoing is true and correct.
.�%���;�. �r � � � !
Si�nature: CourtneyMcKeon NOV 1 7 2005
��toG ,G O:
W� <��L�J��( GIBSON COUhTY AUDITOR
Signature: Iman Satori
TO: _/�
C� S ol� �Ol,�- n`�-� � CL� �-c.� Gr ��I� f
Please Change the follo���ing record(s)/account(s) to reflect name change:
C, f� G-��
p���-�I
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END OPERATOR DRIVER LICENSE
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DLN:047a f 9-7205
ESPIRES:U✓21R007
IMAN C SATORI
638 W DIVISION 5T
OAKLAND CITY. IN 47660
wn or s�nn� rn��sucnoF Mo. nsu�
06't1/1967 51191770003 O9Ag/ZppS
Hncrrt wiwHr �u�n ero ae: oo«on
5-03 115 BRO BLU F � I
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IN TI-� GIBSON CIRCUIT COURT 2005 TERM
At the Courthouse, Princeton, Indiana on the 8`� day of September, 200� �-� �� �� y.M j,
"a,* -:._l� �r'
Present:
Hon. Walter H. Palmer, Justice II SEP � 8 2005
CHANGE OF NAME OF
Courtney Theresa McKeon,
PETITIONER, pro se
���_w3�� �
Ger;: �;�sos; C;ra_$; C:a,�-t
CAUSE NO.: 26C01-O505-MI-0010
FINAL DETERbII�i'ATION OF CAUSE
THIS CAUSE having come on to be heard and the issues therein having been duly
submitted to me for consideration as a Justice of this Court, held in and for Gibson
County, and the petitioner having appeared in person, pro se, presented the pleadings and
�iTitten proof by notary public in support of the s�vom request, and due deliberation
having been had thereon,
NOW, afrer having reviewed and considered the pleadings herein, together with all of
the papers submitted there«�th, I do find and determine the following:
The petitioner was bom Courtney Theresa McKeon, on June 21, 1967 in New York,
New York, and did on the 7'� day of July, 2005, file a REQUEST FOR CI-IANGE OF
NAME �vith the Gibson Counry Clerk.
The petitioner �vas over the age of 18 when this action was commenced.
The petitioner's civil rights were fully intact at the time this action was commenced
and had not ever been suspended at any time prior to this action.
The petitioner has not previouslv changed her name and has had no other sumames or
aliases. ��--,� � ' -t:� �'
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NOV 1 7 2005
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GIBSON CQUNTY AUDITOR 1
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Petitioner wishes to assume name of Iman CouRne� Satori,
,- . _
�purposes, business, personaf, professional and otherwise.
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for all intents and
Petitioner has submitted to this court a Publisher's Affidavit for NOTICE OF
`EUBIICA�'ION having appeared in the Princeton Daily Clarion three times the dates
being July 12, 19, 26, 2005.
That at the time of the commencement of this action and for a continuous period of at
least t�vo years immediately preceding such commencement, the petitioner resided in
Gibson County, Indiana.
This court finds no illegal or fraudulent reason for this request for change of name and
petitioner is not lmo���ngly invading the property rights of another individual or
individuals by making said request.
CONSIDERING the aforementioned findings, and being othenvise fully advised in
this matter. it is therefore
ORDERED AND ADNDGED that said petition be, and the same is hereby fully
granted, and that the name of Courtney Theresa McKeon is hereby changed to Iman
Courtney Satori by which name petitioner shall hereafter be known.
DONE AND ORDERED in Princeton, Gibson Counry, Indiana, this 8`� day of
September, 2005.
ENTER.
.
Hon. Walter H. Palmer, Judge
Gibson Circuit Coun