Page 1 of 3 Approved by the Coalition for Court Access
CCA-GF-0720-3014
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
____________________
PATERNITY
JP
Page 2 of 3 Approved by the Coalition for Court Access
CCA-GF-0720-3014
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 the Coalition for Court Access
CCA-GF-0720-3014
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
____________________
PATERNITY
Page 1 of 1 Approved by the Coalition for Court Access
CCA-JP-0820-1051
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________
CASE NO. ________________________________
IN RE THE PATERNITY OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
VERIFIED PETITION TO ESTABLISH PARENTING TIME WITHOUT AGREEMENT
___________________________________ requests this court to establish a parenting time
order with the parties’ minor child 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 been awarded primary physical custody of the
child.
3. There is no court order regarding parenting time.
4. I am asking the Court to hold a hearing and to enter a parenting time order.
Wherefore, the undersigned prays that the Court set this matter for hearing, that the Court
establish 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 1 Approved by the Coalition for Court Access
CCA-JP-1119-1052
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________
CASE NO. ________________________________
IN RE THE PATERNITY OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
ORDER SETTING HEARING
Comes now __________________________________, pro se, having filed a Verified
Petition To Establish Parenting Time Without Agreement, and the Court finds that the matter
should be set for hearing.
IT IS THEREFORE ORDERED that this matter shall be heard on
_____________________________________________________________________________.
Dated: _________________________________ ____________________________________
Judicial Officer
Distribution:
_______________________________ ________________________________
_______________________________ ________________________________
_______________________________ ________________________________
_______________________________ ________________________________
____________________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-JP-1119-1053
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________
CASE NO. ________________________________
IN RE THE PATERNITY OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
ORDER ESTABLISHING PARENTING TIME
The Court, having reviewed the Verified Petition to Establish Parenting Time Without
Agreement, now enters the following order:
1. On ____________________, ________________________________________
filed a Petition to Establish Parenting Time Without Agreement.
2. The Court set this matter for hearing, and _______________________________
appeared self represented/by counsel and _________________________________appeared
self represented/by counsel. Evidence was heard and concluded.
3. __________________________________ shall have parenting time with the
parties’ minor child, ______________________________ as follows:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SO ORDERED __________________________________________________________
____________________________________
Judicial Officer
Distribution:
_______________________________ ________________________________
_______________________________ ________________________________
_______________________________ ________________________________
_______________________________ ________________________________
____________________