Page 1 of 2 Approved by the Coalition for Court Access
CCA-GF-0520-3022
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________ CAUSE NO. ________________________________
IN RE THE PATERNITY OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
APPEARANCE BY SELF REPRESENTED 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 2 Approved by the Coalition for Court Access
CCA-GF-0520-3022
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
____________________________________
Printed Name
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
____________________________________
____________________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-DC-0520-1071
www.indianalegalhelp.org
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this Response to Notice of Intent to Relocate on
_______________________ by
e-service using the e-filing system
first-class U.S. mail, postage prepaid
hand delivery
to _____________________________________ at the following address:
______________________________
______________________________
______________________________
______________________________
Signature
____________________________________
Printed Name
***You only need to file the following Order Setting Hearing IF
you object to the relocation of the child and asked for a hearing
in the Response To Notice Of Intent To Relocate***
Page 1 of 1 Approved by the Coalition for Court Access
CCA-DC-0520-1072
www.indianalegalhelp.org
STATE OF INDIANA IN THE ___________________________COURT
COUNTY OF ______________________ CAUSE NO. ______________________________
IN THE MATTER OF:
________________________________
Minor Child (Paternity Only)
______________________________
Petitioner
v.
______________________________
Respondent
ORDER SETTING HEARING
Comes now _____________________________________, self represented, having filed
a Response To Notice Of Intent To Relocate, and having requested a hearing, 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:
_________________________________ ___________________________________
_________________________________ ___________________________________
_________________________________ ___________________________________
_________________________________ ___________________________________
____________________