Fillable Use this packet only when the consent of (Indiana Legal Help)

Fill Online, Printable, Fillable, Blank Use this packet only when the consent of (Indiana Legal Help) Form

Use Fill to complete blank online INDIANA LEGAL HELP pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Use this packet only when the consent of (Indiana Legal Help)

On average this form takes 31 minutes to complete

The Use this packet only when the consent of (Indiana Legal Help) form is 36 pages long and contains:

  • 0 signatures
  • 15 check-boxes
  • 117 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your Indiana Legal Help forms online.

BROWSE INDIANA LEGAL HELP FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Page 1 of 1 Approved by the Coalition for Court Access
CCA-MI-0820-2000(C)
www.indianalegalhelp.org
INSTRUCTIONS: CHILD NAME CHANGE WITHOUT CONSENT
☐Use this packet only when the consent of the other parent is not required.
Consent (or agreement) to the Name Change of a Minor may or may not be required.
Consent is not required when, for example, the other parent has abandoned or deserted
the minor, failed to communicate significantly with the minor, or if the parent has
committed a crime against the child. See Indiana Code 31-19-9 for more information.
If none of the factors in Indiana Code 31-19-9 apply, then consent is required.
See Indiana Code 34-28-2-2. This form packet should only be used when consent is
NOT required by the other parent or guardian.
☐Fill out the forms. There are two ways you can complete these forms:
(a) You can use a computer to fill in the form blanks. After you fill in the blanks
you must print out the forms; or
(b) You can print out the forms and handwrite your answers.
☐Read your local court rules to find out how many copies you will need, and if there
are any additional forms or procedures required in your county.
☐Sign your forms and make copies.
☐Take the originals and copies of your forms to the Clerk of the Court. The Clerk will
provide the case number and process the forms. The Clerk will stamp the forms with a
filing date and give you back a copy.
☐The court will set a hearing date when you file your Petition. Make sure this date is
filled in on the Notice of Petition for Change of Name.
☐You will need to take the Notice of Petition for Change of Name for a Minor to the
person who handles legal notices in your local newspaper. This Notice must appear
once a week for three weeks. The last publication date must be at least thirty days
before your hearing date. If you feel unsafe putting this in the newspaper, see more
instructions beginning on the twelfth page of this packet.
☐The newspaper will send a proof of publication notice to you, which you will attach
to the Notice of Filing Proof of Publication and then file these forms with the Court.
☐Attend the hearing. If you feel unsafe having a public hearing, see more instructions
beginning on the twelfth of this packet.
Once the name of the minor has been changed, the court will send a copy of the Order to the state
department of health and local county health department. It is your responsibility to inform
government agencies, schools, and other interested agencies and businesses of the minor’s new
name.
Page 1 of 2 Approved by the Coalition for Court Access
CCA-GF-0820-3003
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
APPEARANCE BY SELF-REPRESENTED PERSON IN CIVIL CASE
1. My name is _________________________________ and I am the Petitioner, filing this case
on my own behalf. 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:
3. This is an MI case type as defined in Administrative Rule 8(B)(3).
4. There are related cases: (If yes, please indicate below)
☐ Yes
☐ No
Caption and case number of related cases:
Caption: Case No.:
Caption: Case No.:
______________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-GF-0820-3003
www.indianalegalhelp.org
Additional information as required by local rule:
Signature
Page 1 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2047
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
VERIFIED PETITION FOR CHANGE OF NAME OF MINOR
Petitioner, ________________________________________, self-represented,
respectfully petitions the court to change the name of the above-noted child. In support of this
Petition, Petitioner states as follows:
1. Petitioner is the of the child whose name is sought to be
changed.
2. The written consent of the non-petitioning parent or guardian for the name change
of the minor child is filed with this Petition.
3. That child’s current name is .
4. That the child’s date of birth is .
5. That the child’s mailing address is:
______________________________________________________________________________
And if different, the child’s residential address is:
_____________________________________________________________________________
6. That the child’s Indiana driver’s license number/Indiana identification card
number is ______________________________________; and I will bring the child’s Indiana
driver’s license or identification card to my Change of Name Hearing for verification.
7. The following is a list of all of the previous names of the child:
______________________________________________________________________________
______________________________________________________________________________
8. That the child ________ hold a valid United States passport. Proof that the child
is a United States citizen is _______________________________. I will bring this document to
the Change of Name Hearing for verification.
______________
__________
_____________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2047
www.indianalegalhelp.org
9. That the following judgements of criminal conviction of a felony under the law of
any state or the United States have been entered against the child, or I have stated immediately
below that the child does not have any felony convictions:
______________________________________________________________________________
______________________________________________________________________________
10. That changing the child’s name is not an effort to defraud any of the child’s
creditors.
11. That notice of the request for name change has been published in a local
publication as required by law and will be brought to the Change of Name Hearing.
12. That the child is not confined to a Department of Correction facility or a sex or
violent offender who is required to register under Indiana Code 11-8-8.
13. That pursuant to Indiana Code 34-28-2-1, I petition this court to change the
child’s name. Pursuant to Indiana Code 34-28-2-2(b), the reason the change of the child’s name
is requested is:
14. That I request that the child’s name be changed to:
15. That I request that (select one of the following):
☐ The name on the child’s birth certificate not be changed.
☐ The name on the child’s birth certificate be changed to their new, changed
name. Specifically, ___________________________________.
16. The non-petitioning parent or guardian of the minor child has been served with a
copy of this Petition as required by the Indiana Trial rules.
WHEREFORE, I respectfully request that this Court grant this Petition for Name Change
of a Minor, and for all other just and proper relief.
I affirm under penalties for perjury that the foregoing representations and statements
are true.
____________________________________
Signature
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
_____________________________ )
Petitioner )
AFFIDAVIT OF DILIGENT SEARCH
Petitioner, _________________________________________, being duly sworn upon
_________ oath, deposes and states:
1. I am the Petitioner in the above-entitled action and have personal knowledge of
the matters stated herein.
2. I am the ____________ of the Minor Child.
3. I am requesting to change the name of the Minor Child from
__________________________________ to _____________________________________.
4. The non-petitioning parent’s name is ___________________________________.
5. I am unaware of the whereabouts of the non-petitioning parent.
6. I have done a diligent search and cannot find the whereabouts of the non-
petitioning parent.
I affirm under penalties for perjury that the foregoing representations and
statements are true.
___________________________________ ____________________________________
Date Signature
____________________________________
____________________________________
____________________________________
____________________________________
P
age 1 of 1 Approved by the Coalition for Court Access
CCA-MI-0820-2006
www.indianalegalhelp.org
______________
__________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-MI-1120-2048
www.indianalegahelp.org
STATE OF INDIANA IN THE __________________ _______________ COURT
COUNTY OF _________________ CASE NO. ____________________________________
IN RE THE NAME CHANGE OF
MINOR:
_____________________________
Name of Minor
_____________________________
Petitioner
NOTICE OF PETITION FOR CHANGE OF NAME
Notice is hereby given that Petitioner, ________________________________________,
as a self-represented litigant, filed a Verified Petition for Change of Name on
______________________________________________________________________________
to change the name of ____________________________________________________________
to ___________________________________________________________________________.
The Petition is schedule for hearing in the _____________________________________________
Court on ______________________________________________________________________,
which is more than thirty (30) days after the third notice of publication. Any person has the right
to appear at the hearing and to file written objections on or before the hearing date.
__________________________________ ____________________________________
Date Clerk, __________________________Court
______________
Page 1 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2003
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)SS:
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
NOTICE OF FILING PROOF OF PUBLICATION
Petitioner, _____________________________________________, self represented, states as
follows:
1. I have given notice of the Petition for Change of Name of Minor Child, pursuant to
Indiana Code 34-28-2-3.
2. Notice was given by three (3) weekly publications in a newspaper of general circulation
published:
☐ in the county in which the petition is filed in court.
☐ in the nearest adjacent county because no newspaper is published in the county in
which the petition is filed
3. The first notice was published not more than seven (7) days after the date the Petition to
Change Name of Minor Child was filed.
4. The published notice included:
A. The name of the petitioner.
B. The name of the minor child whose name is to be changed.
C. The new name desired.
D. The name of the court in which the action is pending and cause number.
E. The date on which the petition was filed.
______________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2003
www.indianalegalhelp.org
F. The date, time, and location of the hearing.
G. The statement that any person has the right to appear at the hearing and to file
objections.
5. I have attached a copy of the published notice herein as Exhibit A.
6. The attached notice has been verified by the affidavit of a disinterested person.
7. More than thirty (30) days have passed since the final required publication of notice.
I affirm under penalties for perjury that the foregoing representations and statements
are true.
Date Signature
Printed Legal Name
Page 1 of 1 Approved by the Coalition for Court Access
CCA-MI-0820-2004
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE )
OF MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
ORDER SETTING HEARING
Comes now _____________________________________, pro se, having filed a Verified
Petition for Change of Name of Minor, and the Court finds that the matter should be set for hearing.
IT IS THEREFORE ORDERED that this matter shall be heard on
__________________________________________________________________________________.
So ORDERED ____________________________________________________________________
_______________________________________
Judicial Officer
Distribution:
___________________________________________
___________________________________________
___________________________________________
______________
Page 1 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2005
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
ORDER ON VERIFIED PETITION FOR CHANGE OF NAME OF MINOR
Comes now the Court, having reviewed the Verified Petition for Change of Name of
Minor and the Notice of Filing Proof of Publication, now finds as follows:
1. The Minor Child’s current name is
2. The Minor Child resides at :
______________________________________________________________________________
3. The Minor Child’s date of birth is : ____________________________________.
4. If the Minor Child has a felony conviction within the last ten (10) years, the
required notice to the appropriate agencies has been provided.
5. The Petitioner wishes to change the Minor Child’s name to:
______________________________________________________________________________
6. The Petitioner:
☐wishes to change the Minor Child’s name on Minor Child’s birth certificate.
☐does not wish to change Minor Child’s name on Minor Child’s birth
certificate.
7. This Order is in accordance with the best interest of the Minor Child as guided by
Indiana Code 31-17-2-8.
______________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2005
www.indianalegalhelp.org
WHEREFORE, IT IS ORDERED that Petitioner’s Petition for Change of Name of
Minor is GRANTED, and Minor’s name is hereby changed to:
____________________________________________________________________________
The name on Minor’s birth certificate:
☐ should be changed to _______________________________________________.
☐ should not be changed.
SO ORDERED ________________________________________________________________
______________________________
Judicial Officer
Distribution:
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-MI-0820-2000(B)
You do not have to file the following documents, but you may want to. Read below and
then decide whether you want to fill out and file them.
To get a name change, you are required to publish notice of your name change in a
newspaper and the court records are public. However, court rules allow you to ask that
the publication requirement be waived (not required), and the records be sealed (not
available to the public) for your safety. If you feel unsafe publishing in a newspaper (for
example, because you are transgender), or having this case public would put you at
significant risk of substantial harm, fill out all of the following forms and submit them
to the Clerk of Court when you start your name change case.
1. The first document is Notice of Exclusion of Confidential Information
From Public Access. This lets the court know you want the court to keep the papers you
file out of public view.
2. The second document is the Verified Request to Prohibit Public Access
Pursuant to Indiana Rules on Access to Court Records. This is a request to the Judge to
make your case confidential. This is where you should detail all the reasons you would
feel unsafe having your name change made public
3. The third document is the Memorandum of Law in Support of Verified
Request to Prohibit Public Access Pursuant to Rules on Access to Court Records.
Indiana Legal Services wrote this memo to explain to the Judge why, in general, it can
be unsafe for trans people to be outed, and why this means the name change of a
transgender person should be sealed (confidential).
4. The fourth document is the Public Notice of Hearing. The law says that if
you ask a judge to make the case confidential, there must be a public hearing on the
sealing request (that’s the second document listed above). To let the public know about
the hearing, the court posts this notice in the courthouse at least 30 days before the
hearing.
5. Finally, the fifth document is the Order on Request to Prohibit Public
Access Pursuant to Indiana Rules on Access to Court Records. This is a document that
you want the Judge to sign. If the Judge decides that your case should remain
confidential, not viewable by the public, then the Judge will sign this document and
your case will be sealed.
Page 1 of 1 Approved by the Coalition for Court
Access CCA-MI-1120-2038
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF MINOR: )
)
_____________________________ )
Name of Minor )
)
_____________________________ )
Petitioner )
NOTICE OF EXCLUSION OF CONFIDENTIAL INFORMATION FOR PUBLIC
ACCESS
Contemporaneous with the filing of their Verified Petition For Change Of Name Of
Minor, __________________________________ and pursuant to Indiana Rules on Access to
Court Records, Petitioner provides this notice that the information listed below is to remain
excluded from public access in accordance with Rule 6:
1. Appearance
2. Verified Petition for Change of Name of Minor
3. Consent to Change of Name of Minor
4. Notice of Filing Proof of Publication
5. Notice of Petition for Change of Name
6. Order Setting Hearing
7. Order on Verified Petition for Change of Name of Minor
8. Notice of Exclusion of Confidential Information for Public Access
9. Verified Request to Prohibit Public Access Pursuant to Indiana Rules on Access to Court
Records
10. Memorandum of Law in Support of Verified Request to Prohibit Public Access And
/Or
Waive Publication Pursuant to Rules on Access to Court Records
11. Order on Verified Request To Prohibit Public Access Pursuant to Indiana Rules on
Access to Court Records
_____________________________________ __________________________________
Signature Date
_____________________________________
Printed Legal Name
______________
Page 1 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2039
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
VERIFIED REQUEST TO PROHIBIT PUBLIC ACCESS PURSUANT TO INDIANA
RULES ON ACCESS TO COURT RECORDS
I, ___________________________________________________, respectfully petition this
Court to seal the record of my child’s name change proceeding, permanently prohibiting Public
Access to the entire court record pursuant to Indiana Rules on Access to Court Records Rule 6. In
support of this request, I state:
1. I am requesting the court change my child’s name because they are:
☐transgender
☐gender non-conforming
☐nonbinary
☐_______________________
2. I am seeking to change my child’s name to accurately reflect my child’s gender identity
and presentation.
3. I am aware of the high rates of violence, discrimination, and invasion of privacy against
transgender, gender non-conforming and nonbinary people in Indiana and nationwide and I fear that
if the public knows my child’s gender identity, they will personally experience violence,
discrimination and an invasion of privacy.
4. I fear that if someone could find my child’s name change request and address online, that
they could be targeted for discrimination and/or violence based on their gender identity.
5. I also fear for my child’s safety because of personal experience with violence and
discrimination.
______________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-MI-0820-2039
www.indianalegalhelp.org
6. My child has personally suffered ☐ physical harm ☐ discrimination ☐ harassment
☐ bullying ☐ threats of violence ☐ other:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
7. I am attaching a Memorandum of Law in Support of Verified Request to Prohibit Public
Access And/Or Waive Publication Pursuant to Rules on Access to Court Records prepared by
Indiana Legal Services as an Exhibit.
THEREFORE, I respectfully request that pursuant to the Indiana Rules on Access to
Court Records, this case be excluded from public access by sealing the record of this proceeding.
I affirm under penalties for perjury that the foregoing representations and statements
are true.
Date Signature
Printed Legal Name
MEMORANDUM OF LAW IN SUPPORT OF
VERIFIED REQUEST TO PROHIBIT PUBLIC ACCESS AND/OR WAIVE
PUBLICATION PURSUANT TO RULES ON ACCESS TO COURT RECORDS
1. This memorandum of law was drafted by Indiana Legal Services’ LGBT Project to support self-
represented litigants who fear for their safety to a request pursuant to the Rules on Access to
Court Records
2
to waive publication and sale the records of their case.
2. Name change cases are subject to the public access rules containing in Indiana Rules of Court
Administration 9. Ind. Code § 34-28-2-2.5(b).
I. HAVING TO PUBLISH NOTICE IN A NEWSPAPER AND HAVING THEIR CASE
PUBLICLY AVAILABLE PUTS PETITIONER AT SUBSTANTIAL RISK OF HARM.
3. The Court of Appeals is clear that the evidence of heightened risk of harassment, violence, and
homicide to transgender individuals nationally and in Indiana is enough to demonstrate significant
risk of harm warranting prohibiting public access. In re Name Change of M.E.B., 19A-MI-118 at
¶ 11 (June 21, 2019).
4. The purpose of the Access to Court Records Rule is, among other things, to minimize an
individual’s risk of injury. The Commentary to the Rule recognizes “that unrestricted access to
certain information in Court Records could result in an unwarranted invasion of personal privacy
or unduly increase the risk of injury to individuals and businesses.” Ind. Access to Court Records
1, cmt. “. . . The goal of the Rules on Access to Court Records is proactive; it seeks to prevent
harm. To force petitioners to wait until they have already experienced that harm would vitiate the
purpose of the rule.” Id.; accord In Re K.H., 127 N.E.3d 257 (Ind. Ct. App. 2019)
5. A.C.R. Rule 6 requires Judges to look at the totality of the circumstances to evaluate if a substantial
risk of harm exists and to proactively protect applicants’ safety. Rule 6 does not require that
Plaintiff endure targeted threats, violence, or abuse before granting temporary and permanent
2
The Access to Court Records Rules replaced Administrative Rule 9 on January 1, 2020. Rules on Access to Court Records
moved portions of Administrative Rule 9 and placed them in a more organized manner. A.C.R. Rule 6 is Administrative Rule
9(G)(4) without change.
Page 1 of 6
Approved by the Coalition for Court Access
CCA-MI-0820-2027
www.indianalegalhelp.org
sealing and a publication waiver. In Re M.E.B., 126 N.E.3d 932 at 934 (Ind. Ct. App. 2019); In Re
K.H., 127 N.E.3d 257 (Ind. Ct. App. 2019)
6. Part of the circumstances to consider is the reality that transgender people are disproportionately
impacted by violence and homicide. The United Sates is the third most deadly country for trans
people.
7. Between 2013 and 2015, hate crimes against transgender people increased 239 percent, with LGBT
people more likely than any other minority group to experience hate crimes in the United States.
Haeyoung Park and Iaryna Mykhyalyshyn, L.G.B.T. People Are More Likely to Be Targets of Hate
Crimes Than Any Other Minority Group, N.Y. TIMES, June 16, 2016.
8. The systemic violence transgender people experience neither begins nor ends with hate crimes,
physical assault or homicide. Transgender people are more likely than the general population to
experience discrimination, harassment, and violence in every facet of life, including family
relations, education, employment, housing, public accommodations, obtaining accurate
identification documents, and accessing adequate and appropriate medical treatment. . See e.g.
James et al., The Report of the 2015 U.S. Transgender Survey (2016), available at
http://www.ustranssurvey.org/reports/; National Coalition of Anti-Violence Programs, A Report
from the National Coalition of Anti-Violence Programs: Lesbian, Gay, Bisexual, Transgender,
Queer, and HIV-Affected Hate Violence in 2013 (2014), available at http://avp.org/wp-
content/uploads/2017/04/2013_ncavp_hvreport_final.pdf; Jaime M. Grant et al., Injustice at Every
Turn: A Report of the National Transgender Discrimination Survey 2 (2011), available at
http://www.thetaskforce.org/downloads/reports/reports/ntds_full.pdf.
9. This is no less true in the state of Indiana. A survey of transgender people in Indiana conducted in
conjunction with the National Transgender Discrimination Survey found that 73% of respondents
reported harassment in their K-12 school; and 27% reported physical assault. National Center for
Transgender Equality and the National Gay and Lesbian Task Force, Findings of the National
Page 2 of 6
Approved by the Coalition for Court Access
CCA-MI-0820-2027
www.indianalegalhelp.org
Transgender Discrimination Survey: Indiana Results (2015), available at
http://www.transequality.org/sites/default/files/docs/usts/USTSINStateReport% 281017%29.pdf.
10. In another study of Transgender Hoosiers, 74% of respondents reported experiencing harassment
or mistreatment on the job. Christy Mallory and Brad Sears, Employment Discrimination Based
on Sexual Orientation and Gender Identity in Indiana, August 2017, available at
https://williamsinstitute.law.ucla.edu/research/in_discrimination_ aug_2017/.
11. In 2016, an Indiana transgender woman was shot in the face while their attacker yelled anti-
transgender sentiments. Alleged Hate Group Member Charged in Shooting of Trans Woman in
Indiana, The Advocate (July 17, 2016), available at
http://www.advocate.com/transgender/2016/7/17/alleged-hate-group-member-charged-shooting-
trans-woman-indiana. Across the nation, violence against transgender individuals is on the rise.
Maggie Astor, Violence Against Transgender People Is on the Rise, Advocates Say, N.Y. TIMES,
Nov. 9, 2017.
12. Though the data on violence is staggering, the actual violence against transgender people is likely
much worse, due to the underreporting of crimes. See. E.g. Lucas Waldron, Deadnamed: The way
cops in Jacksonville and other jurisdictions investigate the murders of transgender women adds
insult to injury and may be delaying justice, available at
https://www.propublica.org/article/deadnamed-transgender-black-women-murders-jacksonville-
police-investigation; Emma Keith et. al, Lack of trust in law enforcement hinders reporting of
LBGTQ crimes, available at https://www.publicintegrity.org/2018/08/24/22138/lack-trust-law-
enforcement-hinders-reporting-lbgtq-crimes.
13. The Court of Appeals is clear that these significantly higher rates of discrimination, harassment,
and violence experienced by transgender people as compared to cisgender people (people who are
not transgender) is enough to satisfy that there was clear and convincing evidence that the
Page 3 of 6
Approved by the Coalition for Court Access
CCA-MI-0820-2027
www.indianalegalhelp.org
Petitioner would face a significant risk of substantial harm if their transgender status was disclosed
to the public. In re Name Change of A.L., 81 N.E.3d 283, 291 (2017).
14. The Court of Appeals rejected the trial court’s reasoning that Rule 9 was not applicable because
the petitioner had not shown they were subjected to any specific threats or violence because of
their gender identity. Id. At 290-91. Trial courts have no jurisdiction to disregard appellate
precedent. Cf. Ross v. State, 877 N.E.2d 829, 835 (Ind. Ct. App. 2007) (appellate precedent is
binding on trial courts), trans. denied.
15. There—on an evidentiary record substantively identical to that submitted here—the court found
that the significant risk of harm came from the general public being able to access, on the internet,
in perpetuity, information about petitioner being transgender.
3
Id.
II. COURT DOCUMENTS IDENTIFY PETITIONER AS TRANSGENDER, WHICH
UNLAWFULLY DISCLOSES CONFIDENTIAL MEDICAL INFORMATION IN
VIOLATION OF A.C.R. 5(A)(1).
16. A.C.R. Rule 5(A)(1) mandates that records declared confidential by Indiana statue or court rule
must be excluded from public access. Both medical and mental health records are confidential and
protected from public disclosure.
17. That Petitioner’s is transgender is protected medical information. I.C. § 16-39-3-10 declares a
patient’s “mental health record or testimony related to a patient’s mental health” offered in a legal
proceeding to be a confidential court record.
18. Gender transitions involve both physical and social elements. Social elements, such as wearing
clothing more readily associated with a specific gender, changing one’s name and updating their
identity documents to reflect their experienced sex, are therapeutic treatments for the psychological
treatment of gender dysphoria. STANDARDS OF CARE FOR THE HEALTH OF TRANSSEXUAL,
3
A publication notice in a local newspaper lives on past the three weeks in which it is published. All public
notices published in Indiana are archived and searchable though the Hoosier State Press Association. Indiana
Public Notice Search, available at http://www.indianapublicnotices.com/
. Once publication is made or the court
file accessed, it cannot be undone.
Page 4 of 6
Approved by the Coalition for Court Access
CCA-MI-0820-2027
www.indianalegalhelp.org
TRANSGENDER, AND GENDER-NONCONFORMING PEOPLE, WORLD PROFESSIONAL ASSOCIATION
FOR
TRANSGENDER HEALTH (7
th
ed. 2011), available at https://www.wpath.org/publications/soc.
19. The records in this case constitute protected health records that Indiana law requires trial courts to
keep confidential. See Ind. Code § 16-39-3-10 (a “mental health record or testimony related to a
patient’s mental health” offered in a legal proceeding is a confidential court record). Trial courts
have no discretion, and therefore no jurisdiction, to order such records be made publicly available.
E.g. Groth v. Pence, 67 N.E.3d 1104, 1112 (Ind. Ct. App. 2017) (“as a matter of law,” records
declared confidential by statute “shall not be disclosed”), trans. denied.
III. BEING OUTED AS TRANSGENDER VIOLATES PETITIONER’S PRIVACY
INTERESTS PROTECTED BY THE ACCESS TO COURT RECORDS RULES AND
THE 4TH AMENDMENT OF THE US CONSTITUTION.
20. The purpose of the Rules on Access to Court Records is, among other things, to protect the privacy
interests of litigants. The Commentary to the Rule recognizes “that unrestricted access to certain
information in Court Records could result in an unwarranted invasion of personal privacy or
unduly increase the risk of injury to individuals and businesses.” Ind. Access to Court Records
Rule 1, cmt.
21. Petitioner has a fundamental right of privacy in preventing the release of their highly personal and
intimate medical and mental health information and in deciding under what circumstances to
release information that has a statistically significant likelihood to subject them to substantial
harm. Whalen v. Roe, 429 U.S. 589, 599-600 (1977); Nixon v. Adm’r of Gen. Servs., 433 U.S. 425,
464-65 (1977) (instructed that intrusions on legitimate informational privacy expectations must be
weighed against the public interest in accessing that information); NASA v. Nelson, 562 U.S. 134,
138 (2011) (reaffirming Nixon balancing test); Denius v. Dunlap, 209 F.3d 944, 956 (7
th
Cir. 2000)
(holding 4
th
Amendment right to informational privacy protects the “clearly established
‘substantial’ right in the confidentiality of medical information that can only be overcome by a
sufficiently strong state interest”).
Page 5 of 6
Approved by the Coalition for Court Access
CCA-MI-0820-2027
www.indianalegalhelp.org
22. The United States Supreme Court has recognized that a constitutional right to information privacy
protected by the 4th Amendment applies to the states under the 14th Amendment. Whalen v. Roe,
429 U.S. 589, 599-600 (1977). This constitutional right to privacy means one has a venerable right
“not to have intimate facts concerning one’s life disclosed without one’s consent.” Bartnicki v.
Vopper, 200 F.3d 109, 122 (3d Cir. 1999). In fact, “the more intimate or personal the information,
the more justified is the expectation that it will not be subject to public scrutiny.” Fraternal Order
of Police v. City of Philadelphia, 812 F.2d 105, 112 (3d Cir. 1987). This right to privacy has been
deemed by Federal Courts to include an individual’s gender identity. See Powell v. Schriver, 175
F.3d 107 (2d Cir. 1999).
23. Denying Petitioner’s Access to Court Records request would make public the fact that Petitioner
is pursuing therapeutic treatment for their gender dysphoria and reveal medical and mental health
information to a large number of disinterested persons with no legitimate interest in that
information, in violation of the 14
th
Amendment to the United States Constitution, I.C. § 16-39-3-
10, and the purpose of the Access to Court Records Rule.
Prepared in January 2020 for use by pro se parties by:
LGBT Law Project
Indiana Legal Services
lgbtgroup@ilsi.net
Page 6 of 6
Approved by the Coalition for Court Access
CCA-MI-0820-2027
www.indianalegalhelp.org
Page 1 of 1 Approved by the Coalition for Court Access
CCA-MI-0820-2036
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)SS:
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
PUBLIC NOTICE OF HEARING
Please take notice: Petitioner having filed a Verified Request To Prohibit Public Access
Pursuant to Indiana Rules on Access to Courts and for Sealing the Record pursuant to Indiana
Rules on Access to Court Records requesting that the Court enter an Order excluding the entire
case from public access, now and the Court having duly examined said motion, hereby sets the
matter for hearing on
______________________________________________________________________________
_____________________________ _______________________________________
Dated Judicial Officer
Distribution:
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
______________
Page 1 of 1 Approved by the Coalition for Court Access
CCA-MI-0820-2037
www.indianalegalhelp.org
STATE OF INDIANA ) IN THE __________________ _______________ COURT
)SS:
COUNTY OF _________________ ) CAUSE NO. ____________________________________
IN RE THE NAME CHANGE OF )
MINOR: )
)
_____________________________ )
Name of Minor )
)
)
)
_____________________________ )
Petitioner )
ORDER ON VERIFIED REQUEST TO PROHIBIT PUBLIC ACCESS PURSUANT TO
INDIANA RULES ON ACCESS TO COURT RECORDS
Following a hearing on the matter, held on ________________________________________ the
Court now issues the following Findings and Order:
1. Petitioner has demonstrated by clear and convincing evidence that the requirements of Indiana
Rules on Access to Court Records Rule 6(A) are met.
2. Petitioner demonstrated that the personal safety interests served by prohibiting public access to
the entire court record of this case outweigh the public access interests served by the Rules on
Access to Court Records.
3. Permanently prohibiting Public Access to the entire court record is the least restrictive means
and duration to protect Petitioner’s and Minor Child’s personal safety.
THEREFORE, IT IS ORDERED that Public access to the documents that comprise the entire
court record under this case number is permanently prohibited and all Public access to all further
proceedings under this case number is prohibited.
So ordered this _________________________________________________________________
____________________________________
Judicial Officer
Distribution:
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
_____________________________ _____________________________
______________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Use this packet only when the consent of (Indiana Legal Help)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 31 December 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document