Fill - Free fillable Minor Child (Indiana Legal Help) PDF form

Page 1 of 3 Approved by the Coalition for Court Access

CCA-DC-0519-3018

STATE OF INDIANA ) IN THE __________________ ______________ COURT

)SS:

COUNTY OF _________________) CAUSE NO. ________________________________

IN RE THE PATERNITY OF:

__________________________

Minor Child

__________________________

Petitioner,

v.

__________________________

Respondent.

APPEARANCE BY UNREPRESENTED PERSON IN PATERNITY CASE

This Appearance Form must be filed on behalf of every party in a civil case.

1. My name is _________________________________ and I am:

☐ Initiating (filing)

☐ Responding (answering or defending)

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.

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 JP case type as defined in Administrative Rule 8(B)(3).

__________________

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CCA-DC-0519-3018

4. There are related cases: (If yes, please indicate below)

☐ Yes

☐ No

Caption and case number of related cases:

Caption: Case No.:

Additional information as required by local rule:

Signature

CERTIFICATE OF SERVICE

I hereby certify that I sent a copy of this Appearance by first class mail to the opposing

party’s attorney, or to the opposing party if the opposing party is not represented by an attorney at

the address listed below on ______________________________.

_________________________________

Signature

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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#________________________________

NOT FOR PUBLIC ACCESS

__________________

_____

STATE OF INDIANA ) IN THE ______________ _______________ COURT

)SS:

COUNTY OF __________________ ) CASE NO. ___________________________________

IN THE MATTER OF THE PATERNITY OF:

_______________________________

Minor Child

_______________________________

Petitioner,

v.

_______________________________

Respondent.

VERIFIED PETITION TO ESTABLISH PATERNITY

Comes now ___________________________________, self represented, and states or

affirms as follows:

1. _____________________________, mother, currently resides at

_________________________________________________________________________________

in the County of _____________________, State of Indiana.

2. _____________________________, father, currently resides at:

_________________________________________________________________________________

in the County of _____________________, State of Indiana.

3. The mother, _____________________________, gave birth to the child

_______________________ out of wedlock on ______________________________.

4. At the time the child was conceived and born the parties were not married to each other.

5. The child, ________________________, currently resides at:

_________________________________________________________________________________

in the County of _____________________, State of Indiana.

6. That ____________________ is the biological father of the child.

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Approved by the Coalition for Court Access

CCA-JP-0519-1063

__________________

WHEREFORE,_____________________________ requests that this Court set this matter for

hearing, and upon hearing enter an order establishing the paternity of _______________________,

child support, parenting time, custody and for all other further relief that is just and proper in the

premises.

I affirm under the penalties of perjury that the foregoing representations are true.

____________________________________ _________________________________

Signature Date

____________________________________

Printed Name

CERTIFICATE OF SERVICE

I hereby certify that I sent a copy of this Petition by first class mail to the opposing

attorney, or the opposing party if the opposing party is not represented by an attorney, at the

following address on ______________________.

_____________________________

____________________________________

_________________________________

Signature

Date

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Approved by the Coalition for Court Access

CCA-JP-0519-1063

STATE OF INDIANA ) IN THE ______________ _______________ COURT

)SS:

COUNTY OF __________________ ) CASE NO. ___________________________________

IN THE MATTER OF THE PATERNITY OF:

_______________________________

Minor Child

_______________________________

Petitioner,

v.

_______________________________

Respondent.

SUMMONS

AND NOTICE OF INITIAL HEARING IN A PATERNITY CASE

THE STATE OF INDIANA TO:

A paternity action has been filed in the Court stated above. A copy of the Petition (and, in some

cases, other documents) is served with this Summons and contain important details regarding the

nature of these proceedings.

An answer or other appropriate response in writing to the petition must be filed either by you or your

attorney within twenty (20) days, starting the day after you receive this Summons, (or twenty-

three (23)- days if this Summons was received by mail) OR A DECISION MAY BE MADE

AGAINST YOU BY DEFAULT AND A FINAL ORDER MAY BE ENTERED DETERMINING

PATERNITY, CUSTODY, PARENTING TIME AND CHILD SUPPORT. If you have a claim for

relief against the plaintiff arising from the same transaction or occurrence, you must assert it in your

written answer. You have rights in this case, including the right to a jury trial

If this Summons is accompanied by an Order Setting Hearing, you must appear in Court on the date

and time stated on the Order Setting Hearing. IF YOU DO NOT APPEAR, EVIDENCE MAY BE

HEARD AND A DECISION MAY BE MADE BY THE COURT. If you wish to hire an attorney to

represent you in this matter, it is advisable to do so before that date.

If you do not file a written appearance with the Clerk and serve a copy on the attorney, or other party

if the other party does not have an attorney, in this matter, you may not receive notice of any further

proceedings in this action.

The following manner of service is designated:

☐ Certified Mail ☐ Sheriff

Date: __________________ ____________________________________

CLERK, ____________________COURT

By: ________________________________________

Deputy Clerk

Approved by the Coalition for Court Access

CCA-JP-0519-1064

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__________________

CLERK'S CERTIFICATE OF MAILING

I hereby certify that on the _____day of ___________________, 20____, I mailed a copy of this Summons

and a copy of the Petition to the party being served, ______________________________________ , by mail,

requesting a return receipt, at the address furnished by the filing party.

Date: __________________ ____________________________________

CLERK, ____________________COURT

By: ________________________________________

Deputy Clerk

RETURN ON SERVICE OF SUMMONS BY MAIL

I hereby certify that the attached return receipt was received by me showing that the Summons and a copy of

the Petition mailed to the party being served,_____________________________ , was accepted by the party

being served on the ____ day of _____________________, 20____ .

I hereby certify that the attached return receipt was received by me showing that the Summons and a copy of

the Petition was returned not accepted on the ____ day of ___________________, 20____ .

Date: __________________ ____________________________________

CLERK, ____________________COURT

By: ________________________________________

Deputy Clerk

RETURN OF SERVICE OF SUMMONS BY SHERIFF

I hereby certify that I have served the within Summons:

1. By delivering on ____________________ , 20____ , a copy of this Summons and a copy of the

Petition to each of the within named person(s).

2. By leaving on _______________________ , 20____ , for each of the within named person(s)

a copy of the Summons and a copy of the Petition at the respective dwelling house or usual place of abode, in

_________________________________, Indiana, with a person of suitable age and discretion residing

within, whose usual duties or activities include prompt communication of such information to the person

served, or by otherwise leaving such process thereat, and by mailing a copy of the Summons without the

Petition to the said named person(s) at the address listed herein.

3. This Summons came to hand this date,______________________ , 20____ . The within named

was not found in my bailiwick this date,___________________________ , 20_____ .

ALL DONE IN ____________________COUNTY, INDIANA.

____________________________________________

SHERIFF OF _______________COUNTY, INDIANA

By: ____________________________________

SERVICE ACKNOWLEDGED

I hereby acknowledge that I received a copy of the within Summons and a copy of the Petition at

____________________________________________________in ____________________, Indiana, on this

date,_____________________ , 20___ .

___________________________________________

Signature of Party Served

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Approved by the Coalition for Court Access

CCA-JP-0519-1064

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STATE OF INDIANA ) IN THE ______________ _______________ COURT

)SS:

COUNTY OF __________________ ) CASE NO. ___________________________________

IN THE MATTER OF THE PATERNITY OF:

_______________________________

Minor Child

______________________________

Petitioner,

v.

_______________________________

Respondent.

ORDER SETTING HEARING

Comes now _____________________________________, self represented, having filed a

Verified Petition To Establish Paternity, and the Court finds that the matter should be set for hearing.

IT IS THEREFORE ORDERED that this matter shall be heard on

__________________________________________________________________________________.

____________________________________ _____________________________________

Date Judicial Officer

☐ The Clerk shall serve this pleading upon __________________________________ by

certified mail at the following address:

____________________________________________

☐ The Clerk shall have this pleading served upon _____________________________ by

sheriff at the following address:

____________________________________________

Distribution:

___________________________________________

CCA-JP-0519-1065

__________________

Page 1 of 4 Approved by the Coalition for Court Access

CCA-JP-0519-1066

STATE OF INDIANA ) IN THE ______________ _______________ COURT

)SS:

COUNTY OF __________________ ) CASE NO. ___________________________________

IN THE MATTER OF THE PATERNITY OF:

_______________________________

Minor Child

_______________________________

Petitioner,

v.

_______________________________

Respondent.

ORDER ESTABLISHING PATERNITY, CUSTODY, CHILD SUPPORT AND

PARENTING TIME

The Court having reviewed the Verified Petition To Establish Paternity and having held a

hearing in this matter, now finds the following:

1. _______________________________ is the biological father of minor child,

__________________________________.

2. _______________________________ is the biological mother of minor child,

__________________________________.

3. Custody and care of the minor child(ren).

It is in the best interest of the child(ren) that:

☐ The parties shall have joint legal custody over the minor child(ren) with

Petitioner being the primary custodial parent.

☐ The parties shall have joint legal custody over the minor child(ren) with

Respondent being the primary custodial parent.

☐ Petitioner shall have sole legal custody of the minor child(ren) and shall be

the primary custodial parent.

☐ Respondent shall have sole legal custody of the minor child(ren) and shall

be the primary custodial parent.

☐ Other, as described below:

__________________

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____________________________________________________________

4. Parenting Time

Parenting time with the minor child(ren) shall be as follows:

☐

Petitioner

☐ Respondent

shall have parenting time with the minor child(ren), at a

minimum, as set out by the Parenting Time Guidelines

☐

Other

it is in the best interests of the minor child(ren) to follow a

parenting time schedule that does NOT follow the Indiana

Parenting Time Guidelines. Parenting time with the

minor child(ren), shall be as follows:

______________________________________________

5. Child Support

☐ Petitioner

☐ Respondent

will pay child support in the amount of $______________

per week as shown by the attached child support

worksheet, beginning on the first Friday following the

date of the Decree. All support payments shall be made

through the County Clerk’s Office (cash payments only)

or the State Central Collection Unity PO Box 7130,

Indianapolis, Indiana 46207-7130 (any payments other

than cash). The court shall issue an immediately activated

Income Withholding Order pursuant to IC 31-16-15 to

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any employer or income provider of the child support

Obligor.

☐ Petitioner

☐ Respondent

shall be responsible for all controlled expenses related to

the upbringing of the minor child(ren).

☐ Petitioner

☐ Respondent

will be responsible for the first ________________ of

annual uninsured health and medical, dental, optical,

hospital and prescription expenses for the minor

child(ren). Thereafter, Petitioner shall be responsible for

________% of annual uninsured medical expenses for the

minor child(ren), and Respondent shall be responsible for

__________ % of annual uninsured medical expenses for

the minor child(ren).

☐ Petitioner

☐ Respondent

will be responsible to pay a child support arrearage in the

amount f $_________________ which has accrued during

the pendency of this proceeding. Such arrearage shall be

paid in the periodic amount of $________________ per

week in addition to the current support rendered above,

until such arrearage has been satisfied.

6. Health insurance

The provisions for health insurance maintenance shall be as follows:

☐

Petitioner

☐ Respondent

shall maintain medical, dental and optical insurance as

available through employment, or Health Insurance

Marketplace, or by government provided insurance for the

minor child(ren).

☐

Other

Health insurance is not available to either parent at a

reasonable cost, therefore, neither party is ordered to

provide health insurance at this time.

In the event that health insurance for the children becomes

available at a reasonable cost to one or both of the parties,

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CCA-JP-0519-1066

the party to whom such coverage is available shall obtain

coverage for the children within a reasonable time after

such coverage becomes available.

7. Taxes

The arrangement for claiming the tax credits, exemptions and deductions for the minor

children shall be as follows:

☐ Petitioner

☐ Respondent

shall be entitled to claim the minor child(ren) for federal,

state, and local income tax purposes on an annual basis.

The parties shall cooperate to sign all necessary

documents that will allow the party claiming the

exemptions to do so.

☐

Other

Petitioner and Respondent shall each be entitled to claim

the minor child(ren) for federal, state, and local income

tax purposes in alternating years.

Petitioner shall be entitled to claim the minor child(ren) in

the year _________, and every ___________ year

thereafter.

Respondent shall be entitled to claim the minor child(ren)

in the year _________, and every ___________ year

thereafter. The parties shall cooperate to sign all

necessary documents that will allow the party claiming

the exemption to do so.

SO ORDERED THIS ______________________________________________________

__________________________________________

Judicial Officer

Distribution:

Petitioner’s Name and Mailing Address: Respondent’s Name and Mailing Address:

_________________________________ __________________________________

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Fillable Minor Child (Indiana Legal Help)

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