Page 1 of 3 Approved by the Coalition for Court
Access CCA-GF-1020-3014
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________ CASE NO. ________________________________
IN RE THE __________________ OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
APPEARANCE BY UNREPRESENTED PERSON
1. My name is _________________________________ and in this case I am not represented
by a lawyer.
2. My contact information for receiving legal service of documents and case information as
required by Court Rules is:
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
3. This is a ________ case type as defined in Administrative Rule 8(B)(3).
4. There are other cases related to this case: (If yes, please indicate below)
Yes
No
____________________
_____
_____
Page 2 of 3
Approved by the Coalition for Court Access
CCA-GF-10
20-3014
www.indianalegalhelp.org
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
e-service using the e-filing system
first-class U.S. mail, postage prepaid
hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________
Signature
Page 3 of 3
Approved by th
e Coalition for Court Access
CCA-GF-1020-3014
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________ CASE NO. ________________________________
IN RE THE ___________________ OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
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
CIVIL APPEARANCE FORM
Social security numbers of parents and minor child
Name: SS#
Name: SS#
Name: SS#
Name: SS#
Name: SS#
Name: SS#
NOT FOR PUBLIC ACCESS
____________________
____________________
Page 1 of 1
Appro
ved by the Coalition for Court Access
CCA-JP-1020-1048
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF _______________
IN THE ________________ _______________ COURT
CASE NO. ___________________________________
IN RE THE PATERNITY OF:
____________________________
Minor Child
____________________________
Petitioner,
v.
____________________________
Respondent
VERIFIED PETITION TO ESTABLISH PARENTING TIME WITH AGREEMENT
______________________________________, self represented, files a Petition To
Establish Parenting Time and states in support as follows:
1. Paternity of the parties’ minor child, ____________________________ has been
established by this Court or by the execution of a paternity affidavit.
2. ___________________________________ has primary physical custody of the
minor child.
3. There is no court order regarding parenting time.
4. ____________________________________ asks the Court to enter a parenting
time order in accordance with the parties’ Agreed Entry.
WHEREFORE, the undersigned prays that the Court enter an order establishing parenting
time and for all other just and proper relief.
I affirm under penalties for perjury that the foregoing representations and
statements are true.
_______________________________ ______________________________
Date Signature
______________________________
Printed Name
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this document on ________________________ by
e-service using the e-filing system
first-class U.S. mail, postage prepaid
hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________
Signature
____________________
Page 1 of 2 Approved by the Coalition for Court Access
CCA-JP-1020-1049
www.indianalegalhelp.org
STATE OF INDIANA IN THE ________________ _______________ COURT
COUNTY OF __________________ CASE NO. ___________________________________
IN RE THE PATERNITY OF:
____________________________
Minor Child
____________________________
Petitioner,
v.
____________________________
Respondent
VERIFIED AGREED ENTRY ESTABLISHING PARENTING TIME
___________________________________ and ______________________________
file an Agreed Entry Establishing Parenting Time and state they agree as follows:
1. Paternity of the parties’ minor child, ____________________________ has been
established by this Court or by the execution of a paternity affidavit.
2. ___________________________________ has primary physical custody of the
minor child.
3. There is no court order regarding parenting time.
4. ______________________________ and ________________________________
waive a hearing and ask the Court to enter a parenting time order
in accordance with the Indiana Parenting Time Guidelines OR
as follows:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-JP-1020-1049
www.indianalegalhelp.org
WHEREFORE, the undersigned pray that the Court order parenting time consistent with
this Verified Agreed Entry Establishing Parenting Time, and for all other just and proper relief.
I affirm under penalties for perjury that the foregoing representations and
statements are true.
Date: ______________________________ ____________________________________
Petitioner Signature
____________________________________
Printed Name
STATE OF INDIANA
COUNTY OF ______________________
Before me, _______________________________, a notary public in and for
__________________________ County, State of Indiana, personally appeared
_______________________________________ and having been duly sworn upon their oath says
that the facts all alleged in the foregoing instrument are true.
Date: _______________________________ ____________________________________
Notary Public
My Commission Expires ____________________________________________
I affirm under penalties for perjury that the foregoing representations and statements
are true.
Date: ______________________________ ____________________________________
Respondent Signature
____________________________________
Printed Name
STATE OF INDIANA
COUNTY OF ______________________
Before me, _______________________________, a notary public in and for
__________________________ County, State of Indiana, personally appeared
_______________________________________ and having been duly sworn upon their oath says
that the facts all alleged in the foregoing instrument are true.
Date: _______________________________ ____________________________________
Notary Public
My Commission Expires ____________________________________________
SO ORDERED ________________________________________________________________
____________________________________
Judicial Officer
Distribution:
__________________________________ ____________________________________
__________________________________ ____________________________________
__________________________________ ____________________________________