Page 1 of 2 Approved by the Coalition for Court Access
CCA-DC-0520-1071
www.indianalegalhelp.org
STATE OF INDIANA IN THE ___________________________COURT
COUNTY OF ______________________ CAUSE NO. ______________________________
IN THE MATTER OF:
________________________________
Minor Child (Paternity Only)
______________________________
Petitioner
v.
______________________________
Respondent
RESPONSE TO NOTICE OF INTENT TO RELOCATE
Comes now, ________________________________ and files this Response To Notice Of
Intent To Relocate and states as follows:
☐ I DO NOT object to the relocation of the child(ren) and I DO NOT request a
modification of custody, parenting time, grandparent visitation or child support.
OR
☐ I DO NOT object to the relocation of the child and I plan to request a hearing on
the modification of the following: ☐Custody ☐Parenting Time ☐Grandparent Visitation
☐Child Support
AND
☐ We HAVE participated in mediation or another alternative dispute resolution
process about the relocation of the child.
☐ We HAVE NOT participated in mediation or another alternative dispute
resolution process about the relocation of the child.
OR
☐ I OBJECT to the relocation of the child(ren)
AND
I request a hearing for a :
☐ (i) a temporary or permanent order to prevent the relocation of the child; and
☐ (ii) the modification of a custody, parenting time, grandparent visitation, or child
support order as a result of the relocation.
AND
☐ We HAVE participated in mediation or another alternative dispute resolution
process about the relocation of the child.
☐ We HAVE NOT participated in mediation or another alternative dispute
resolution process about the relocation of the child.
Respectfully submitted,
____________________________________
Signature
____________________________________