Fill and Sign the In Name Change 497307089 Form

STATE OF INDIANA ) IN THE       CIRCUIT COURT ) SS: COUNTY OF       ) CASE NO.       IN RE CHANGE OF ) NAME OF MINOR: )       ) )       ) Petitioner. ) APPEARANCE BY SELF-REPRESENTED PERSON IN CIVIL 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)       ; or Intervening       ; in this case on behalf of a minor. 2. Contact information for receiving legal service of documents and case information is required by Court Rules: (NOTE: If you are the Initiating party and this case, or a related case, involves a protection from abuse order, a workplace violence restraining order, or a no-contact order, you must provide an address for the purpose of legal service of documents but that address should not be one that exposes the whereabouts of a petitioner.) Address:             Email Address:       Phone:       FAX:       OR, if in the related case, you have used the Attorney General Confidential address, you may check the box below: ___ Attorney General confidential address (contact the Attorney General at 1-800-321-1907 or e-mail address is confidential@atg.state.in.us ) . 3. This is a _________ case type as defined in administrative Rule 8(B)(3). (Clerk will supply this information.) 4. I will accept service by FAX at the following number       Page 1 of 2 Form TCM-TR3.1-6 Approved by State Court Administration 12/10 5. This case is a domestic relations matter, involves reciprocal enforcement of support, paternity, delinquency, Child in Need of Services (CHINS), guardianship, or any other proceedings in which support may be an issue, and social security numbers of all family members are supplied on a separately attached document (Form TCM-TR3.1-4) filed as confidential information on light green paper.       Yes       No 6. There are related cases: Yes       No       (If yes, please indicate below.) Caption and case number of related cases: Caption:       Case Number:       Caption:       Case Number:       Caption:       Case Number:       Caption:       Case Number:       Caption:       Case Number:       Caption:       Case Number:       7. Additional information required by local rule:       Self-Represented Party Page 2 of 2 Form TCM-TR3.1-6 Approved by State Court Administration 12/10