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Arkansas _______________________ (Position, if applicable) _________ ___________________________________ (Name) ___________________________________ (Position, if applicable) _________________________________ _________________________________ (Name) __________egal representatives, successors and permitted assigns of the Parties. IN WITNESS WHEREOF, the parties have caused this Amendment to be executed the day and year written above. _______________________ this Amendment, in which event the terms of this Amendment shall control. BINDING EFFECT: The covenants and conditions contained in this Amendment shall apply to and bind the parties and the heirs, lgree that all other terms, conditions and obligations of the Contract remain in effect throughout the term of the Contract except for those provisions of the Contract that are directly contradicted by_______________________________________________________________ ____________________________________________________________________________ ________________ OTHER TERMS OF THE CONTRACT: The Parties a________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ______________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________s: AMENDMENT: The Contract is amended as follows: [Describe the amendment below or attach it as an exhibit to this document] _____________________________________________________________________________________________________________________________ ___________________________ (the "Contract"); and WHEREAS, the Parties wish to amend the Contract. NOW, THEREFORE, the Parties hereby agree as follow_________________________________________________, who may collectively be referred to as the "Parties." WHEREAS, the Parties entered into an agreement dated ________________, 20__ regarding _________ert your name] AMENDMENT TO CONTRACT This Amendment to Contract (the "Amendment") is entered as of ____________________, 20____ by and between ________________________________________ and ___________tions or need additional information or documentation, please do not hesitate to contact me at (______) ________-______________. Thank you for your prompt attention to this matter. Yours Truly, [Ins_____________________[insert name] Please change the name on the account to my new name: ___________________ ______________________________________________________________________ If you have any quesE: ACCT. # [insert account number if applicable] To Whom It May Concern: I am writing to inform you that I have recently been divorced and have changed my name. The current name on my account is: _____-______________. Thank you for your prompt attention to this matter. Yours Truly, [Insert your name] SAMPLE LETTER 2 [Insert Date] Client Services [Insert Company Name] [Insert Company Address] Rreet Address ___________________________________ City, State and Zip If you have any questions or need additional information or documentation, please do not hesitate to contact me at (______) ____________________________ Former City, State and Zip Please change the name and address on the account to the following: ___________________________________ New Name ___________________________________ Stve changed my name and address. The current name and address for my account are ___________________________________ Former Name ___________________________________ Former Street Address ______________t Services [Insert Company Name] [Insert Company Address] RE: ACCT. # [insert account number if applicable] To Whom It May Concern: I am writing to inform you that I have recently been divorced and haforms for the address change can be found at your local post office or on the web at: http://www.usps.com/moversguide/ Divorce ­ Name Change Kit (Instructions) 6 SAMPLE LETTER 1 [Insert Date] Clienbegin receiving mail under your new name. You don't need to officially contact the U.S. Postal Service to inform them of your name change, but you will need to inform them of any address changes. The m you have an ongoing relationship and inform them of your name change. This may be done either on the phone, or by using one of the letters enclosed with this package. [_] Post Office. You will soon mple name change, but may wish to contact the company for membership adjustments. [_] Doctors and Other Medical Personnel. You should contact any doctors, dentists, or other medical personnel with who change. Again, there may be additional steps to take if you maintained a joint membership at these clubs or organizations with your spouse. You can use one of the enclosed sample letters to make a siw 1044 or other forms. [_] Clubs and Organizations. If you are a member of a club or organization, you should either call their member services number, or send them a letter informing them of you nameare at least inclined to trust you because you work with them. In any case, usually you will need only to contact your personnel department and inform them of the change. They may have you complete neract amendment with this kit. [_] Employee Documents. Making changes to employee documents (personnel records, W-2s, paychecks) is usually quite easy. You work with these people, so they know you, or formation on that agreement. Review your copy of these agreements, or contact your lawyer, to determine what steps you must take to change your name. For your reference we have included a generic conty legal contracts (e.g., leases, supply contracts, services contracts), they will need to be amended to reflect your new name. Generally, each contract will specify the steps necessary to amend any int officer to discuss what steps you need to take to complete these changes. Forms for amending your will can also be found at www.findlegalforms.com. [_] Contracts. If you personally are a party to anour name on any will, trust, or other similar document. In addition, in connection with your divorce, you may also want to change your beneficiary or make other amendments. Contact your lawyer or trusu. They may require that you send them written notification of this change. If that is the case, you can use one of the sample letters included in this kit. [_] Wills, Trusts, etc. You should change yound on your last statement). If you wish to remove your spouse from this insurance, Divorce ­ Name Change Kit (Instructions) 5 this may involve additional steps of which your carrier will inform yoame car, home, or life insurance that you had during your marriage, you will need to contact your carrier to inform them of your name change. Give your carrier a call (the contact information can be f new name and will not have or reflect your spouse's. You may use one of the attached sample letters to notify your credit card companies of this change. [_] Insurance. If you intend to maintain the s you may have kept ownership of that account. If this is the case, it is a good idea to change your name on that card, not only to avoid confusion, but because your driver's license will now have youruestions that you may have. [_] Credit Cards. If, during your marriage, you and your spouse shared a credit card, that account may be dissolved and you may need to apply for a new card. Alternatively,ttlement, you may need to establish new accounts for your property. This should be a fairly straightforward process, and representatives associated with those institutions will be able to answer any qe). In some instances, you may need to appear in person with your former spouse to sign off on the transfer. In some instances, if the property (i.e., the accounts) has been divided in your divorce se come in person and present them with acceptable proof of identity (this proof required will change depending on the institution, but they will generally accept your divorce decree and driver's licensnt accounts you have been awarded. Contact your bank or other financial services provider and ask them what the procedure for a name change is. Often, these types of institutions will require that youmaintained during your marriage are deemed your property in your divorce settlement, you will need to inform those institutions of your name change. This will include any saving, checking, or investmeis purpose. The first includes a change of address as well as a change of name. The second is a name change only. [_] Bank and Investment Accounts. To the extent that the bank and investment accounts ess is very casual and is often best completed by making a phone call to the appropriate office. If they request a letter or if you would prefer to send one, we have included two Sample Letters for thities. If you are remaining at your old house or apartment, all of your utility statements (including water, gas, electricity, internet, cable, etc.) will need to be changed to your new name. The procpublic library. All of these institutions should have the forms you need. For more information you can check the Federal Election Commission's website at: http://www.fec.gov/pages/electpg.htm [_] Utiltion information and amendment opportunities on the same form with license amendments. Just ask the clerk at the DMV what you need to do. You can also visit your local city hall, county courthouse or orce ­ Name Change Kit (Instructions) 4 [_] Voter Registration. Typically you can change your voter registration at the same time you change your driver's license. Many states include voter registraormation are included with the form. Form 8822 can be accessed from this link http://www.irs.gov/pub/irspdf/f8822.pdf or http://www.findlegalforms.com/public/f8822.pdf in Adobe Acrobat PDF format. Divtact the IRS within 10 days to report the change. If you have also changed your address, you will need to complete Form 8822 (access information can be found below). Mailing instructions and other inftion on Form DS-11, visit http://travel.state.gov/passport/forms/ds11/ds11_842.html. [_] Federal Tax Information. Once you have contacted and made your name change official with the SSA, they will conPA 15262-0001 Option 3 If you don't qualify for either option 1 or option 2, you will need to reapply for you passport by submitting Form DS-11. This will require additional documentation. For informa National Passport Processing P.O. Box 371971 Pittsburg, PA 15250-7971 If using other delivery service Passport Services Lockbox ATTN: Password Supervisor 371971 500 Ross St, Room 154-0670 Pittsburg, os of you alone (2"x2"), and a check for the fee amount. The fee for this service is $67. The form, divorce decree, new photos, old passport and fee should be sent to: If using the U.S. Postal Service843.html or at http://www.findlegalforms.com/public/ds0082.pdf. Along with your completed form, you will need to send a certified copy of your divorce decree, your old passport, two recent, color photst 16 years old when the passport was issued and iii) the passport was issued within the last 15 years. You can download this form off the internet at http://travel.state.gov/passport/forms/ds82/ds82_stle, DE 19720 Option 2 If your passport was issued more than one year ago, you will need to use either Form DS-82 or DS-11. Use form DS-82 if: i) you can submit your old passport; ii) you were at leasing P.O. Box 13290 Philadelphia, PA 19101-3290 If using other delivery service Divorce ­ Name Change Kit (Instructions) 3 National Passport Processing ATTN: Department 13290 1617 Brett Road New Capassport and divorce decree will be returned to you by priority mail. The form, divorce decree, new photos and old passport should be sent to: If using the U.S. Postal Service National Passport Procesorm, you will need to send a certified copy of your divorce decree, your old passport and two recent, color photos of you alone (2"x2"). There is no fee for this service. Once completed, your amended rm). You can download this form off the internet at http://www.travel.state.gov/passport/forms/ds5504/ds5504_2663.html and/or http://www.findlegalforms.com/public/DS5504.pdf Along with the completed ff you have a U.S. passport, your name should be amended. Option 1 If your passport is currently valid and was issued within the last year, you can use Form DS-5504 (the U.S. Passport Re-application Fon sticker expires soon, you may make appropriate corrections on the renewal application; however, the title and registration must be corrected at the same time. [_] Passport. Form DS-5504 and DS-82. I. The procedures for this change will vary from institution to institution, but a representative of your financing company should be able to walk you through the process. Note that if your registrationtact information for which is linked above. If your vehicle is being financed, you will need to contact the institution that is financing your vehicle in order to complete a name change on your titleish change your name on your title and registration documents, you need to apply for a new title in your new name. Forms to complete this change are available at your local Arkansas Revenue Office, co generally $20. To locate the nearest Arkansas Revenue Office visit http://www.arkansas.gov/dfa/motor_vehicle/mv_map.php. [_] Vehicle Title and Registration. If you own the title to your vehicle and wld license and a copy of your certified divorce decree or other dissolution of Divorce ­ Name Change Kit (Instructions) 2 marriage documents reflecting your name change. The fee for this service ispublic/ss5.pdf in Adobe Acrobat PDF format. [_] Driver's License. To change your name on your driver's license you must go in person to your local Revenue Office where you will be asked to show your o.S. Government Agencies in your telephone book or you can call 1-800-772-1213. Form SS-5 can be downloaded from the following link. http://www.ssa.gov/online/ss-5.pdf or http://www.findlegalforms.com/y Office in person. Once completed, the form should be mailed (along with the original or certified copy of your divorce decree) to your local Social Security Office. The office will be listed under U SS-5 form, you will also need to mail your original divorce decree. If you feel uncomfortable mailing an original or a certified copy of your divorce decree, you can visit your nearest Social Securitete Form SS-5 (access information can be found below). You will need to provide proof of your name change--your divorce decree will qualify. The SSA requires the original document, so if you mail yourment of Motor Vehicles (the "DMV") will check with the SSA to ensure that the information is the same before issuing you a new driver's license. To change your name on your social security card, compl Card. Form SS-5. You should change your name with the Social Security Administration (the "SSA") before attempting to change your name on your driver's license. The reason for this is that the Departdivorce to facilitate this process. Step 3: Changing Documents and Identification. To keep from getting confused or overlooking one of the forms, check each off as you complete it. [_] Social Securityranted. The clerk can tell you how much the certified copy will cost and how soon it can be delivered to you. It may be helpful to provide your local clerk with the docket number associated with your any of the enclosed forms. Step 1: Certified Copies of Your Divorce Decree. If you need another copy of your divorce decree, you can visit the county or city clerk's office at which your divorce was g_____ Other:____________________ Instructions Divorce ­ Name Change Kit Arkansas Step 1: Read the Instructions Carefully. You need to read these instructions as well as the instructions contained in _____________________ Doctors and Other Medical Personnel 1) _______________________ 2) _______________________ 3) _______________________ 4)________________________ Post Office Other:__________________________ 2) _______________________ 3) _______________________ 4)________________________ Insurance Companies 1) _______________________ 2) _______________________ 3) _______________________ 4)________ 4)________________________ Employee Documents 1) _______________________ 2) _______________________ 3) _______________________ 4)________________________ Clubs and Organizations 1) ____________, etc. 1) _______________________ 2) _______________________ 3) _______________________ 4)________________________ Contracts 1) _______________________ 2) _______________________ 3) _____________________________ 3) _______________________ 4)________________________ Credit Cards 1) _______________________ 2) _______________________ 3) _______________________ 4)________________________ Wills, Trustsgistration Utilities 1) _______________________ 2) _______________________ 3) _______________________ 4)________________________ Bank and Investment Accounts 1) _______________________ 2) ____________or all serious legal matters. Divorce ­ Name Change Kit (Information) 2 Divorce ­ Name Change Kit Checklist Social Security Card Driver's License Vehicle Registration/Title Passport I.R.S. Voter Rend on any theory of liability, whether in contract, strict liability or tort (including negligence or otherwise) arising in any way out of the use of these materials. An attorney should be consulted fental, special, exemplary or consequential damages (including, but not limited to, procurement of substitute goods or service, loss of use, data, or profits or business interruption), however caused as for your particular needs. The materials are used at your own risk. In no event will FindLegalForms, Inc., its agents, partners or affiliates be responsible or liable for any direct, indirect, incidTerms of Use" found at findlegalforms.com. These materials are provided "AS-IS." We do not give any express or implied warranties of merchantability, suitability or completeness of any of the materialer No Attorney-Client relationship is created by use of these materials. FindLegalForms, Inc. does not provide legal advice. The purchase and use of these materials is subject to the "Disclaimers and ewriter. The forms linked in this packet may be modified by the State of Arkansas from time to time, so you should check with your local government agency to ensure that they are up to date. Disclaim forms to which we provide access may be in Adobe Acrobat PDF format. You will need a free Adobe Acrobat Viewer to view and use them. PDF forms usually have to be either filled out by hand or on a type appropriate fields or you can fill them out manually. If you are filling out the forms manually and are not using a typewriter, use black ink and print as legibly and neatly as possible. Some of the Amendment; Links to Form SS-5 (social security); Links to U.S. Passports Forms; and Links to Form 8822 (I.R.S.) You can fill out the forms on the computer by entering the requested information in ths the following forms: (i) (ii) (iii) Information for the Name Change Kit; Checklist; Instructions for the Name Change Kit; (iv) (v) (vi) (vii) (viii) (ix) Sample Letter 1; Sample Letter 2; Contractntly or soon to be divorced. You may not use this packet if you are: (i) (ii) under the age of 18; or changing your name for fraudulent or other improper purposes. Materials This form packet containd a helpful checklist to ensure that you don't miss any thing. Good luck. Requirements To use this packet you must be: (i) Over the age of 18; (ii) a resident of the state of Arkansas; and (iii) recethis. That's where we come in. This kit contains: forms that you will need to change your name on government documents; letters notifying companies, organizations, and agencies of your name change; an as a legal name change. You don't have to go to court again or get any other official decrees. But although you have legally changed your name, your records and identification cards will not reflect mer name and beginning your life anew. We hope to make this process as quick and as painless as possible. As a point of reference, a divorce decree granted by the state showing your new name qualifiesInformation Divorce ­ Name Change Kit Arkansas Overview Divorce can be a draining and confusing process for all parties. This name change kit is designed to simplify the process of reclaiming your for Arkansas