Fillable Form CCA-DC-0819-1068 Notice of Extension (Indiana)

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Form CCA-DC-0819-1068 Notice of Extension (Indiana)

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Page 1 of 2 Approved by the Coalition for Court Access
CCA-GF-0819-3020
STATE OF INDIANA IN THE COURT
COUNTY OF CAUSE NO.________________________________
IN RE THE __________________ OF:
__________________________
Minor Child (paternity cases only)
__________________________
Petitioner,
v.
__________________________
Respondent.
APPEARANCE BY UNREPRESENTED PERSON IN CIVIL CASE
1. My name is _________________________________ and I am:
☐ Petitioner
☐ Respondent
and in this case I am not represented by a lawyer.
2. Contact information for receiving legal service of document and case information as required
by Court Rules. (NOTE: If you are the Initiating Party and this case, or a related case,
involves a protection from abuse order, a workplace violence restraining order, or a no-
contact order, you must provide an address for the purpose of legal service of documents.
But, that address should not be one that exposes your location.)
Address:
Email address:
☐ I will accept service at the above email address.
Phone:
Fax:
OR, if in a related case, you have used the Attorney General confidential address, you may
check the box below:
☐ Attorney General confidential address
______
_____
Page 2 of 2 Approved by the Coalition for Court Access
CCA-GF-0819-3020
3. This is a DC case type as defined in Administrative Rule 8(B)(3).
4. There are related cases: (If yes, please indicate below)
☐ Yes
☐ No
Caption and case number of related cases:
Caption: Case No.:
Caption: Case No.:
Caption: Case No.:
Additional information as required by local rule:
Signature
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by first-
class U.S. mail, postage prepaid to ____________________________________________ at the
following address:
______________________________
______________________________
______________________________
AND
I hereby certify that I sent a copy of this document on _______________________ to the
State of Indiana, ____________________________County Prosecutor’s Office, Child Support
Division
☐ by first-class U.S. mail, postage prepaid at the following address:
______________________________
______________________________
______________________________
OR
☐by E-service using the Indiana E-filing
_______________________________________
Signature
Page 1 of 1 Approved by the Coalition for Court Access
CCA-DC-0320-1069
www.indianalegalhelp.org
NOT FOR PUBLIC ACCESS
IN ACCORDANCE WITH INDIANA RULES ON
ACCESS TO COURT RECORDS
ATTENTION CLERK: FOR SELF REPRESENTED LITIGANTS TREAT THIS FORM AS IF IT
IS PRINTED ON LIGHT GREEN PAPER. IF E-FILED, FILE AS A CONFIDENTIAL
DOCUMENT.
STATE OF INDIANA IN THE ____________________ ___________ COURT
COUNTY OF __________________ CAUSE NO: _____________________________
IN THE ________________OF
_______________________
Minor Child (paternity only)
_______________________
Petitioner
vs.
_______________________
Respondent
CIVIL APPEARANCE FORM
Social security numbers of all family members in cases involving child support
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
NOT FOR PUBLIC ACCESS
______
_____
Page 1 of 2 Approved by the Coalition for Court Access
CCA-DC-0819-1067
A STATE OF INDIANA IN THE _______________ ___________ COURT
COUNTY OF __________________ CAUSE NO: _____________________________
IN THE ___________________ OF
_______________________
Minor Child (paternity only)
_______________________
Petitioner
vs.
_______________________
Respondent
NOTICE TO THE COURT REQUESTING AN EXTENSION
OF THE DUTY TO SUPPORT A CHILD
Comes now ________________________________ and hereby notifies the Court,
pursuant to IC 31-16-6-6 as follows:
1. That _________________________________is the parent or guardian of
___________________________________________, born ____________________.
2. That said child is at least seventeen (17) years old and will turn age nineteen (19)
on___________________________.
3. That said child is currently enrolled as a full-time student in a secondary school
(as defined by IC 20-18-2-18), specifically ________________________________________
and that proof of said enrollment is attached hereto.
4. That said child is expected to graduate from the above secondary school on or
about _____________________________________.
______
_____
Page 2 of 2 Approved by the Coalition for Court Access
CCA-DC-0819-1067
Wherefore,_______________________________________ requests that the child
support for said child continue until the date of graduation provided above and that the
Court order the support to be terminated as of that date and for all other proper relief.
Date: ___________________________ __________________________________________
Signature
__________________________________________
__________________________________________
__________________________________________
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
first-class U.S. mail, postage prepaid to ____________________________________________
at the following address:
______________________________
______________________________
______________________________
AND
I hereby certify that I sent a copy of this document on _______________________ to the
State of Indiana, ____________________________County Prosecutor’s Office, Child Support
Division
☐ by first-class U.S. mail, postage prepaid at the following address:
______________________________
______________________________
______________________________
OR
☐by E-service using the Indiana E-filing
______________________________
Signature
Page 1 of 2 Approved by the Coalition for Court Access
CCA-DC-0819-1068
STATE OF INDIANA IN THE _______________ ___________ COURT
COUNTY OF __________________ CAUSE NO: _____________________________
IN THE ___________________ OF
_______________________
Minor Child (paternity only)
_______________________
Petitioner
vs.
_______________________
Respondent
ORDER ON REQUEST FOR AN EXTENSION OF THE DUTY TO SUPPORT A CHILD
The Court having reviewed the Notice To The Court Requesting An Extension Of
The Duty To Support A Child now finds and orders as follows:
1. Thirty (30) or more days have passed since the filing of the Notice To The
Court Requesting An Extension Of The Duty To Support A Child.
2. No objection or request for hearing has been filed.
3. That _________________________________is the parent or guardian of
___________________________________________, born ____________________.
4. That said child is at least seventeen (17) years old and will turn age nineteen
(19) on___________________________.
5. That said child is currently enrolled as a full-time student in a secondary
school (as defined by IC 20-18-2-18), specifically__________________________________.
6. That said child is expected to graduate from the above secondary school on
or about _____________________________________.
7. That the child support for said child shall continue until the date of
graduation provided above.
______
_____
Page 2 of 2 Approved by the Coalition for Court Access
CCA-DC-0819-1068
8. That the child support for said child shall terminate as of the date of
graduation provided above.
SO ORDERED _______________________________________________________________
____________________________________
Judicial Officer
Distribution:
_________________________________ ____________________________________
_________________________________ ____________________________________
_________________________________ ____________________________________
_________________________________
_________________________________
_________________________________
County Prosecutor
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Form CCA-DC-0819-1068 Notice of Extension (Indiana)

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Completed 18 August 2020

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