Page 1 of 1 Approved by the Coalition for Court Access
CCA-DC-1220-1078
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF ______________________
IN THE ___________________________ COURT
CASE NO. ______________________________
IN TH
E MATTER OF:
________________________________
Minor Child (Paternity Only)
______________________________
Petitioner
v.
_______________
_______________
Respondent
MOTION FOR HEARING ON INTENT TO RELOCATE AND MODIFICATION
Comes now, ___________________________________________________ and respectfully states
as follows:
1. _____________________________________________________________ filed an objection to
_______________________________________________’s notice of intent to relocate without request
for a hearing at the time of filing the objection.
2. The parties:
☐Have participated in mediation or another alternative dispute resolution process about
relocation of the child; OR
☐Have not participated in mediation or another alternative dispute resolution process about
relocation of the child
3. Based upon the above representations, _____________________________________ respectfully
requests that the court set this matter for hearing.
WHEREFORE, ___________________________________ requests that this Court set this matter
for hearing and for all other relief just and proper in the premises.
Respectfully submitted,
Signature
____________________________________
Printed Name
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this Motion For Hearing On Intent To Relocate And Modification 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
________________________________
________________________________
___________________________________________
