Fill and Sign the In This Case and I Am Not Represented by a Lawyer Form

Page 1 of 2 Form TCM-TR3.1-7 Revised by State Court Administration 09/2014 STATE OF INDIANA ) IN THE SUPERIOR / CIRCUIT COURT 1 ) SS: CIVIL DIVISION, ROOM 2 COUNTY OF ) CASE NO. 3 IN RE THE OF: 4 5 Petitioner, 6 and 7 8 Respondent. 9 APPEARANCE BY UNREPRESENTED PERSON IN CIVIL CASE 10 This Appearance Form must be filed on behalf of every party in a civil case. 11 1. My Name is: and I am 12 Initiating (filing) 13 Responding (answering or defending) 14 Intervening 15 in this case, and I am not represented by a lawyer. 16 2. Contact information for receiving legal service of documents and case information is required by 17 Court Rules: (NOTE: If you are the Initiating party and this case, or a related case, involves a 18 protection from abuse order, a workplace violence restraining order, or a no-contact order, you 19 must provide an address for the purpose of legal service of documents but that address should 20 not be one that exposes the whereabouts of a petitioner. ) 21 Address: 22 23 24 Email Address: 25 I will accept service at the above email address. 26 Phone: 27 F ax : 28 I will accept service at the above fax number. 29 OR, if in the related case, you have used the Attorney General Confidential address, you may 30 check the box below: 31 Attorney General confidential address. 32 Page 2 of 2 Form TCM-TR3.1-7 Revised by State Court Administration 09/2014 3. This is a case type as defined in administrative Rule 8(B)(3). 33 (The clerk will tell you the case type if you don’t know it, so you may handwrite your response at 34 the Clerk’s Office. ) 35 4 . This case is a domestic relations matter, involves reciprocal enforcement of support, paternity, 36 delinquency, Child in Need of Services (CHINS), guardianship, or any other proceedings in 37 which support may be an issue, and social security numbers of all family members are supplied 38 on a separately attached document (Form TCM-TR3.1-4) filed as confidential information on 39 light green paper. 40 Yes 41 No 42 5 . There are related cases: (If yes, please indicate below.) 43 Yes 44 No 45 Caption and case number of related cases: 46 Caption: Case Number: 47 Caption: Case Number: 48 Caption: Case Number: 49 Caption: Case Number: 50 Caption: Case Number: 51 Caption: Case Number: 52 7. Additional information required by local rule: 53 54 55 Signature 56