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MAIDEN NAME RESTORATION REQUEST—COLUMBIA JUDICIAL CIRCUIT LAST UPDATED 10/17/2022 Page 1 of 1 IN THE SUPERIOR COURT OF COLUMBIA COUNTY STATE OF GEORGIA , * PLAINTIFF, * * CASE NUMBER: v. * * , * DEFENDANT. * REQUEST TO RESTORE MAIDEN NAME Comes (current name) , and does hereby amend her pleadings to request that her maiden name or prior married name be restored, to-wit: (PRINT NAME WHICH IS TO BE RESTORED) This day of (Signature of Party – Current Name) (Print Current Name of Party) Plaintiff / Defendant