Fillable YOUR NAME LEAVE BLANK Minor Child NAME OF (Indiana Legal Help)

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YOUR NAME LEAVE BLANK Minor Child NAME OF (Indiana Legal Help)

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Page 1 of 3 Approved by the Coalition for Court Access
CCA-DC-0519-3018
STATE OF INDIANA
) IN THE __________________ ______________ COURT
)SS:
COUNTY OF _________________) CAUSE NO. ________________________________
IN RE THE PATERNITY OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
APPEARANCE BY UNREPRESENTED PERSON IN PATERNITY CASE
This Appearance Form must be filed on behalf of every party in a civil case.
1. My name is _________________________________ and I am:
☐ Initiating (filing)
☐ Responding (answering or defending)
in this case 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:
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 JP case type as defined in Administrative Rule 8(B)(3).
COUNTY YOU
WILL FILE IN
COUNTY YOU WILL
FILE IN
COURT YOU WILL FILE IN
LEAVE BLANK IF YOU
DON'T KNOW
LEAVE BLANK
NAME OF CHILD
YOUR NAME
THE OTHER PARENT'S NAME
YOUR NAME
CHECK 'INITIATING'
YOUR MAILING ADDRESS
YOUR EMAIL ADDRESS
CHECK THIS BOX
IF YOU ONLY
WANT
INFORMATION
FROM THE
COURT SENT TO
YOUR EMAIL
YOUR PHONE NUMBER
YOUR FAX (IF YOU HAVE ONE)
__________________
Page 2 of 3 Approved by the Coalition for Court Access
CCA-DC-0519-3018
4. T
here are related cases: (If yes, please indicate below)
☐ Yes
☐ No
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 Appearance by first class mail to the opposing
party’s attorney, or to the opposing party if the opposing party is not represented by an attorney at
the address listed below on ______________________________.
_________________________________
_________________________________
_________________________________
Signature
IF THERE ARE OTHER CASES RELATED TO THIS PATERNITY,
CHECK "YES" AND FILL IN THE INFORMATION BELOW. IF NOT,
CHECK "NO"
IF LOCAL RULE REQUIRES ADDITIONAL INFORMATION, INCLUDE IT HERE
ADDRESS OF THE OTHER PARENT
OR THE OTHER PARENT'S
ATTORNEY
DATE YOU MAIL THIS DOCUMENT
PRINT THIS FORM AND SIGN HERE
Page 1 of 1 Approved by the Coalition for Court Access
CCA-DC-0320-1069
www.indianalegalhelp.org
NOT FOR PUBLIC ACCESS
IN ACCORDANCE WITH INDIANA RULES ON
ACCESS TO COURT RECORDS
A
TTENTION CLERK: FOR SELF REPRESENTED LITIGANTS TREAT THIS FORM AS IF IT
IS PRINTED ON LIGHT GREEN PAPER. IF E-FILED, FILE AS A CONFIDENTIAL
DOCUMENT.
STATE OF INDIANA IN THE ____________________ ___________ COURT
COUNTY OF __________________ CAUSE NO: _____________________________
IN THE ________________OF
_______________________
Minor Child (paternity only)
_______________________
Petitioner
vs.
_______________________
Respondent
CIVIL APPEARANCE FORM
Social security numbers of all family members in cases involving child support
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
Name: ______________________________________SS#________________________________
NOT FOR PUBLIC ACCESS
-----------------------------------------------------------------------------------------------------------------------------------------
FOR THE SECTION ABOVE THE DOTTED LINE, LOOK AT THE
COURT PAPERS YOU HAVE IN YOUR CASE AND COPY THE
INFORMATION HERE.
YOUR NAME YOUR SOCIAL SECURITY NUMBER
CHILD'S NAME CHILD'S SOCIAL SECURITY NUMBER
OTHER PARENT'S NAME OTHER PARENT'S SOCIAL SECURITY NUMBER
STATE OF INDIANA ) IN THE ______________ _______________ COURT
)SS:
COUNTY OF __________________ ) CASE NO. ___________________________________
IN THE MATTER OF THE PATERNITY OF:
_______________________________
Minor Child
_______________________________
Petitioner,
v.
_______________________________
Respondent.
VERIFIED PETITION TO ESTABLISH PATERNITY
Comes now ___________________________________, self represented, and states or
affirms as follows:
1. _____________________________, mother, currently resides at
_________________________________________________________________________________
in the County of _____________________, State of Indiana.
2. _____________________________, father, currently resides at:
_________________________________________________________________________________
in the County of _____________________, State of Indiana.
3. The mother, _____________________________, gave birth to the child
_______________________ out of wedlock on ______________________________.
4. At the time the child was conceived and born the parties were not married to each other.
5. The child, ________________________, currently resides at:
_________________________________________________________________________________
in the County of _____________________, State of Indiana.
6. That ____________________ is the biological father of the child.
Page 1 of 2
Approved by the Coalition for Court Access
CCA-JP-0519-1063
FOR THE SECTION ABOVE THE DOTTED LINE, LOOK
AT THE FIRST FORM YOU FILLED OUT AND COPY
THE INFORMATION HERE
---------------------------------------------------------------------------------------------------------------------------------
YOUR NAME
MOTHER'S NAME
MOTHER'S ADDRESS
MOTHER'S COUNTY
FATHER'S NAME
FATHER'S ADDRESS
FATHER'S COUNTY
MOTHER'S NAME
CHILD'S NAME
CHILD'S BIRTHDATE
CHILD'S NAME
CHILD'S ADDRESS
CHILD'S COUNTY
FATHER'S NAME
__________________
WHEREFORE,_____________________________ requests that this Court set this matter for
hearing, and upon hearing enter an order establishing the paternity of _______________________,
child support, parenting time, custody and for all other further relief that is just and proper in the
premises.
I affirm under the penalties of perjury that the foregoing representations are true.
____________________________________ _________________________________
Signature Date
____________________________________
Printed Name
CERTIFICATE OF SERVICE
I hereby certify that I sent a copy of this Petition by first class mail to the opposing
attorney, or the opposing party if the opposing party is not represented by an attorney, at the
following address on ______________________.
_____________________________
_____________________________
_____________________________
____________________________________
_________________________________
Signature
Date
Page 2 of 2
Approved by the Coalition for Court Access
CCA-JP-0519-1063
YOUR NAME
CHILD'S NAME
PRINT THIS DOCUMENT AND SIGN HERE DATE YOU SIGN THIS FORM
YOUR NAME
DATE YOU MAIL THIS DOCUMENT
OTHER PARENT'S ADDRESS
PRINT THIS FORM AND SIGN HERE
DATE YOU SIGN THIS DOCUMENT
STATE OF INDIANA ) IN THE ______________ _______________ COURT
)SS:
COUNTY OF __________________ ) CASE NO. ___________________________________
IN THE MATTER OF THE PATERNITY OF:
_______________________________
Minor Child
_______________________________
Petitioner,
v.
_______________________________
Respondent.
SUMMONS
AND NOTICE OF INITIAL HEARING IN A PATERNITY CASE
THE STATE OF INDIANA TO:
A paternity action has been filed in the Court stated above. A copy of the Petition (and, in some
cases, other documents) is served with this Summons and contain important details regarding the
nature of these proceedings.
An answer or other appropriate response in writing to the petition must be filed either by you or your
attorney within twenty (20) days, starting the day after you receive this Summons, (or twenty-
three (23)- days if this Summons was received by mail) OR A DECISION MAY BE MADE
AGAINST YOU BY DEFAULT AND A FINAL ORDER MAY BE ENTERED DETERMINING
PATERNITY, CUSTODY, PARENTING TIME AND CHILD SUPPORT. If you have a claim for
relief against the plaintiff arising from the same transaction or occurrence, you must assert it in your
written answer. You have rights in this case, including the right to a jury trial
If this Summons is accompanied by an Order Setting Hearing, you must appear in Court on the date
and time stated on the Order Setting Hearing. IF YOU DO NOT APPEAR, EVIDENCE MAY BE
HEARD AND A DECISION MAY BE MADE BY THE COURT. If you wish to hire an attorney to
represent you in this matter, it is advisable to do so before that date.
If you do not file a written appearance with the Clerk and serve a copy on the attorney, or other party
if the other party does not have an attorney, in this matter, you may not receive notice of any further
proceedings in this action.
The following manner of service is designated:
☐ Certified Mail ☐ Sheriff
Date: __________________ ____________________________________
CLERK, ____________________COURT
By: ________________________________________
Deputy Clerk
Approved by the Coalition for Court Access
CCA-JP-0519-1064
Page 1 of 2
FOR THE SECTION ABOVE THE DOTTED LINE, LOOK
AT THE FIRST FORM YOU FILLED OUT AND COPY
THE INFORMATION HERE
-----------------------------------------------------------------------------------------------------------------------------------
-
OTHER PARENT'S NAME
OTHER PARENT'S ADDRESS
__________________
CLERK'S CERTIFICATE OF MAILING
I hereby certify that on the _____day of ___________________, 20____, I mailed a copy of this Summons
and a copy of the Petition to the party being served, ______________________________________ , by mail,
requesting a return receipt, at the address furnished by the filing party.
Date: __________________ ____________________________________
CLERK, ____________________COURT
By: ________________________________________
Deputy Clerk
RETURN ON SERVICE OF SUMMONS BY MAIL
I hereby certify that the attached return receipt was received by me showing that the Summons and a copy of
the Petition mailed to the party being served,_____________________________ , was accepted by the party
being served on the ____ day of _____________________, 20____ .
I hereby certify that the attached return receipt was received by me showing that the Summons and a copy of
the Petition was returned not accepted on the ____ day of ___________________, 20____ .
Date: __________________ ____________________________________
CLERK, ____________________COURT
By: ________________________________________
Deputy Clerk
RETURN OF SERVICE OF SUMMONS BY SHERIFF
I hereby certify that I have served the within Summons:
1. By delivering on ____________________ , 20____ , a copy of this Summons and a copy of the
Petition to each of the within named person(s).
2. By leaving on _______________________ , 20____ , for each of the within named person(s)
a copy of the Summons and a copy of the Petition at the respective dwelling house or usual place of abode, in
_________________________________, Indiana, with a person of suitable age and discretion residing
within, whose usual duties or activities include prompt communication of such information to the person
served, or by otherwise leaving such process thereat, and by mailing a copy of the Summons without the
Petition to the said named person(s) at the address listed herein.
3. This Summons came to hand this date,______________________ , 20____ . The within named
was not found in my bailiwick this date,___________________________ , 20_____ .
ALL DONE IN ____________________COUNTY, INDIANA.
____________________________________________
SHERIFF OF _______________COUNTY, INDIANA
By: ____________________________________
SERVICE ACKNOWLEDGED
I hereby acknowledge that I received a copy of the within Summons and a copy of the Petition at
____________________________________________________in ____________________, Indiana, on this
date,_____________________ , 20___ .
___________________________________________
Signature of Party Served
Page 2 of 2
Approved by the Coalition for Court Access
CCA-JP-0519-1064
Page 1 of 1 Approved by the Coalition for Court Access
STATE OF INDIANA ) IN THE ______________ _______________ COURT
)SS:
COUNTY OF __________________ ) CASE NO. ___________________________________
IN THE MATTER OF THE PATERNITY OF:
_______________________________
Minor Child
______________________________
Petitioner,
v.
_______________________________
Respondent.
ORDER SETTING HEARING
Comes now _____________________________________, self represented, having filed a
Verified Petition To Establish Paternity, and the Court finds that the matter should be set for hearing.
IT IS THEREFORE ORDERED that this matter shall be heard on
__________________________________________________________________________________.
____________________________________ _____________________________________
Date Judicial Officer
☐ The Clerk shall serve this pleading upon __________________________________ by
certified mail at the following address:
____________________________________________
____________________________________________
____________________________________________
☐ The Clerk shall have this pleading served upon _____________________________ by
sheriff at the following address:
____________________________________________
____________________________________________
____________________________________________
Distribution:
___________________________________________
___________________________________________
CCA-JP-0519-1065
FOR THE SECTION ABOVE THE DOTTED LINE, LOOK
AT THE FIRST FORM YOU FILLED OUT AND COPY
THE INFORMATION HERE
---------------------------------------------------------------------------------------------------------------------------------------
YOUR NAME
LEAVE BLANK
YOUR NAME
OTHER PARENT'S NAME
__________________
Page 1 of 4 Approved by the Coalition for Court Access
CCA-JP-0519-1066
STATE OF INDIANA ) IN THE ______________ _______________ COURT
)SS:
COUNTY OF __________________ ) CASE NO. ___________________________________
IN THE MATTER OF THE PATERNITY OF:
_______________________________
Minor Child
_______________________________
Petitioner,
v.
_______________________________
Respondent.
ORDER ESTABLISHING PATERNITY, CUSTODY, CHILD SUPPORT AND
PARENTING TIME
The Court having reviewed the Verified Petition To Establish Paternity and having held a
hearing in this matter, now finds the following:
1. _______________________________ is the biological father of minor child,
__________________________________.
2. _______________________________ is the biological mother of minor child,
__________________________________.
3. Custody and care of the minor child(ren).
It is in the best interest of the child(ren) that:
☐ The parties shall have joint legal custody over the minor child(ren) with
Petitioner being the primary custodial parent.
☐ The parties shall have joint legal custody over the minor child(ren) with
Respondent being the primary custodial parent.
☐ Petitioner shall have sole legal custody of the minor child(ren) and shall be
the primary custodial parent.
☐ Respondent shall have sole legal custody of the minor child(ren) and shall
be the primary custodial parent.
☐ Other, as described below:
FOR THE SECTION ABOVE THE DOTTED LINE, LOOK
AT THE FIRST FORM YOU FILLED OUT AND COPY
THE INFORMATION HERE
----------------------------------------------------------------------------------------------------------------------------------
FATHER'S NAME
CHILD'S NAME
MOTHER'S NAME
CHILD'S NAME
LEAVE BLANK
__________________
Page 2 of 4 Approved by the Coalition for Court Access
CCA-JP-0519-1066
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
4. Parenting Time
Parenting time with the minor child(ren) shall be as follows:
Petitioner
☐ Respondent
shall have parenting time with the minor child(ren), at a
minimum, as set out by the Parenting Time Guidelines
Other
it is in the best interests of the minor child(ren) to follow a
parenting time schedule that does NOT follow the Indiana
Parenting Time Guidelines. Parenting time with the
minor child(ren), shall be as follows:
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
5. Child Support
☐ Respondent
will pay child support in the amount of $______________
per week as shown by the attached child support
worksheet, beginning on the first Friday following the
date of the Decree. All support payments shall be made
through the County Clerk’s Office (cash payments only)
or the State Central Collection Unity PO Box 7130,
Indianapolis, Indiana 46207-7130 (any payments other
than cash). The court shall issue an immediately activated
Income Withholding Order pursuant to IC 31-16-15 to
LEAVE BLANK
Page 3 of 4 Approved by the Coalition for Court Access
CCA-JP-0519-1066
any employer or income provider of the child support
Obligor.
☐ Respondent
shall be responsible for all controlled expenses related to
the upbringing of the minor child(ren).
☐ Respondent
will be responsible for the first ________________ of
annual uninsured health and medical, dental, optical,
hospital and prescription expenses for the minor
child(ren). Thereafter, Petitioner shall be responsible for
________% of annual uninsured medical expenses for the
minor child(ren), and Respondent shall be responsible for
__________ % of annual uninsured medical expenses for
the minor child(ren).
☐ Respondent
will be responsible to pay a child support arrearage in the
amount f $_________________ which has accrued during
the pendency of this proceeding. Such arrearage shall be
paid in the periodic amount of $________________ per
week in addition to the current support rendered above,
until such arrearage has been satisfied.
6. Health insurance
The provisions for health insurance maintenance shall be as follows:
Petitioner
☐ Respondent
shall maintain medical, dental and optical insurance as
available through employment, or Health Insurance
Marketplace, or by government provided insurance for the
minor child(ren).
☐
Health insurance is not available to either parent at a
reasonable cost, therefore, neither party is ordered to
provide health insurance at this time.
In the event that health insurance for the children becomes
available at a reasonable cost to one or both of the parties,
LEAVE BLANK
Page 4 of 4 Approved by the Coalition for Court Access
CCA-JP-0519-1066
the party to whom such coverage is available shall obtain
coverage for the children within a reasonable time after
such coverage becomes available.
7. Taxes
The arrangement for claiming the tax credits, exemptions and deductions for the minor
children shall be as follows:
☐ Respondent
shall be entitled to claim the minor child(ren) for federal,
state, and local income tax purposes on an annual basis.
The parties shall cooperate to sign all necessary
documents that will allow the party claiming the
exemptions to do so.
Other
Petitioner and Respondent shall each be entitled to claim
the minor child(ren) for federal, state, and local income
tax purposes in alternating years.
Petitioner shall be entitled to claim the minor child(ren) in
the year _________, and every ___________ year
thereafter.
Respondent shall be entitled to claim the minor child(ren)
in the year _________, and every ___________ year
thereafter. The parties shall cooperate to sign all
necessary documents that will allow the party claiming
the exemption to do so.
SO ORDERED THIS ______________________________________________________
__________________________________________
Judicial Officer
Distribution:
Petitioner’s Name and Mailing Address: Respondent’s Name and Mailing Address:
_________________________________ __________________________________
_________________________________ __________________________________
_________________________________ __________________________________
_________________________________ __________________________________
LEAVE BLANK
YOUR NAME
YOUR ADDRESS
OTHER PARENT'S NAME
OTHER PARENT'S ADDRESS
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YOUR NAME LEAVE BLANK Minor Child NAME OF (Indiana Legal Help)

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Completed 31 December 2021

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