Fill and Sign the State of Indiana in the Court County of Cause No in Re Form

IN THE ___________COURT OF _______________ (County), ________________ (State)_________________ PETITIONERV.CAUSE NO. _____________________________ RESPONDENTState of ________________County of ________________ PERSONALLY appeared before me, the undersigned authority in and for said county and state, ____________________ (Petitioner’s Name), who, having been being first duty sworn by the undersigned Notary Public, deposes and says: 1.I am the mother of _______________ (name of child), an infant born on or about ________________ (date), in ________________________________________________ (city, county, state), and am the Petitioner in the above-entitled matter.2. Respondent ______________ (Respondent’s Name) is the father of ______________ (name of child), and the husband of Affiant.3.___________________ (name of child) was born on _________________ (date of birth of minor child). 4.On or about __________________ (date of desertion) , __________________ (Respondent’s Name) deserted Affiant and his child _________________ (name of child) and has not communicated with Affiant or with said Child since that date.5. The last known place of residence of __________________ (Respondent’s Name) was ______________________________________________________________________________ (street address, city, county, state, zip code), but said Respondent is not residing there at the present time, and the present location of Respondent is unknown to Affiant.6.Affiant has had a diligent search made to locate Respondent _________________ (Respondent’s Name), but said Respondent cannot be located. Attached to this affidavit is the affidavit of _____________________ (name of person who made search) , who made the search on behalf of Affiant. WHEREFORE, Petitioner requests that citation for service by publication on __________________ be issued, pursuant to ____________________ (citation to state statute).___________________________________ (Print Name of Petitioner) SWORN to and subscribed before me, this the ______ day of ______________, 20____._____________________________NOTARY PUBLICMy Commission Expires:__________________