Fillable Minor Child Petitioner, (Indiana Legal Help)

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Minor Child Petitioner, (Indiana Legal Help)

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Page 1 of 3 Approved by the Coalition for Court
Access CCA-GF-1220-3014
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________ CASE NO. ________________________________
IN RE THE __________________ OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
APPEARANCE BY UNREPRESENTED 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 3 Approved by the Coalition for Court
Access CCA-GF-1220-3014
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
Page 3 of 3 Approved by the Coalition for Court
Access CCA-GF-1220-3014
www.indianalegalhelp.org
STATE OF INDIANA IN THE __________________ ______________ COURT
COUNTY OF _________________ CASE NO. ________________________________
IN RE THE ___________________ OF:
__________________________
Minor Child
__________________________
Petitioner,
v.
__________________________
Respondent.
NOT FOR PUBLIC ACCESS
IN ACCORDANCE WITH INDIANA RULES ON
ACCESS TO COURT RECORDS
ATTENTION CLERK: FOR SELF REPRESENTED LITIGANTS TREAT THIS FORM AS
IF IT IS PRINTED ON LIGHT GREEN PAPER
CIVIL APPEARANCE FORM
Social security numbers of parents and minor child
Name: SS#
Name: SS#
Name: SS#
Name: SS#
Name: SS#
Name: SS#
NOT FOR PUBLIC ACCESS
__________________
__________________
Page 1 of 2 Approved by the Coalition for Court Access
CCA-JP-1220-1054
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF _______________
IN THE ________________ _______________ COURT
CASE NO. ___________________________________
IN RE THE PATERNITY OF:
____________________________
Minor Child
____________________________
Petitioner,
v.
____________________________
Respondent
VERIFIED PETITION TO MODIFY PARENTING TIME WITH AGREEMENT
__________________________________, self represented, files a Petition To Modify
Parenting Time and states in support as follows:
1. Paternity of the parties’ minor child(ren), namely:
______________________________________________________________________________
has been established by this Court, and ________________________________ has been ordered
to pay child support in the amount of $_____________________ per week.
2. ______________________________ has been awarded primary physical custody
of the child(ren).
3. The Court’s most recent order on parenting time is dated ____________________
and orders parenting time as follows:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. A change in parenting time is in the best interest of the child(ren).
5. ________________________________________ asks the Court to enter a
parenting time order:
☐in accordance with the Indiana Parenting Time Guidelines OR
☐as follows:
__________________
Page 2 of 2 Approved by the Coalition for Court
Access CCA-JP-1220-1054
www.indianalegalhelp.org
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. The parties have reached an agreement and an Agreed Entry To Modify Parenting
Time is filed with this petition.
WHEREFORE, the undersigned prays that the Court modify the current parenting time as
requested, and for all other just and proper relief.
I affirm under penalties for perjury that the foregoing representations and
statements are true.
_______________________________ ______________________________
Date Signature
______________________________
Printed Name
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
Page 1 of 2 Approved by the Coalition for Court
Access CCA-JP-1220-1058
www.indianalegalhelp.org
STATE OF INDIANA
COUNTY OF _______________
IN THE ________________ _______________ COURT
CASE NO. ___________________________________
IN RE THE PATERNITY OF:
____________________________
Minor Child
____________________________
Petitioner,
v.
____________________________
Respondent
VERIFIED AGREED ENTRY TO MODIFY PARENTING TIME
________________________________ and _________________________ file an
Agreed Entry To Modify Parenting Time and state they agree as follows:
1. The paternity of the parties’ minor child(ren) ___________________________
______________________________________________________________________________
has been established by this Court and _____________________________ has been ordered to
pay child support in the amount of $_______________________ per week.
2. _________________________ has been awarded primary physical custody of the
minor child(ren).
3. A change in parenting time is in the best interest of the child(ren).
4. The parties waive a hearing and ask the Court to modify the parenting time order
☐in accordance with the Indiana Parenting Time Guidelines OR
☐as follows:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
__________________
Page 2 of 2 Approved by the Coalition for Court
Access CCA-JP-1220-1058
www.indianalegalhelp.org
WHEREFORE the parties waive their right to a hearing, ask that the Court modify
parenting time as outlined above in the Verified Agreed Entry to Modify Parenting Time and for
all other just and proper relief.
I affirm under penalties for perjury that the foregoing representations and
statements are true.
Date: ______________________________ ____________________________________
Petitioner Signature
____________________________________
Printed Name
STATE OF INDIANA
COUNTY OF ______________________
Before me, _______________________________, a notary public in and for
__________________________ County, State of Indiana, personally appeared
_______________________________________ and having been duly sworn upon their oath says
that the facts all alleged in the foregoing instrument are true.
Date: _______________________________ ____________________________________
Notary Public
My Commission Expires ____________________________________________
I affirm under penalties for perjury that the foregoing representations and statements
are true.
Date: ______________________________ ____________________________________
Respondent Signature
____________________________________
Printed Name
STATE OF INDIANA
COUNTY OF ______________________
Before me, _______________________________, a notary public in and for
__________________________ County, State of Indiana, personally appeared
_______________________________________ and having been duly sworn upon their oath says
that the facts all alleged in the foregoing instrument are true.
Date: _______________________________ ____________________________________
Notary Public
My Commission Expires ____________________________________________
SO ORDERED ________________________________________________________________
____________________________________
Distribution: Judicial Officer
__________________________________ ____________________________________
__________________________________ ____________________________________
__________________________________ ____________________________________
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Minor Child Petitioner, (Indiana Legal Help)

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Completed 31 December 2021

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