Form Administrative Rule 9-G1 STATE OF INDIANA IN THE _____________ COURT, COUNTY OF________ _____________________, Plaintiff(s), vs. _____________________, Defendant(s) ) ) ) ) ) ) ) Case No: ____________________ Administrative Rule 9(G)(5) Notice of Exclusion of Confidential Information from Public Access (FILED WITH TRIAL COURT CLERK) Contemporaneous with the filing of this notice, [party name] has filed confidential information on green paper in accordance with Administrative Rule 9(G)(6). Pursuant to Administrative Rule 9(G)(5), [party name], provides this notice that the confidential information contained on that green paper is to remain excluded from public access in accordance with the authority listed below: Name or description of document filed on green paper. [List here] Administrative Rule 9(G) grounds upon which exclusion is authorized. [List 9(G) grounds here.] [NOTE: If 9(G)(2)(a), 9(G)(2)(b) or 9(G)(3)(b) provides the basis for exclusion, you must also list the specific law, statute, or rule declaring the information confidential.] Respectfully submitted, ___________________________________ [Insert Name] American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF SERVICE I certify that on this _______ day of _______________, 20_____, the foregoing was served upon the following by [state method of service]: [list names and addresses of counsel of record] _________________________ [Signature] American LegalNet, Inc. www.FormsWorkFlow.com