STATE OF INDIANA COUNTY OF (Select One) ) IN THE (Select One) ) SS: ) CASE NO. SUPERIOR/CIRCUIT COURT IN RE THE (Select One) OF: Petitioner, V. Respondent. VERIFIED PETITION TO TERMINATE CHILD SUPPORT DUE TO EMANCIPATION OF MINOR CHILD(REN) Comes now ______________________________, pro se, and hereby files a Verified Petition to Terminate Child Support Due to Emancipation of Minor Child(ren), and states as follows: 1. That parties have __________ minor child(ren), namely: Name Date of birth ______________________________ _________________ ______________________________ _________________ ______________________________ _________________ ______________________________ _________________ 2. On _________________, this Court ordered that ______________________________ pay child support to ______________________________ in the weekly amount of ________________ for the above named child(ren) effective on _________________. 3. The following child(ren) is/are emancipated: _________________________________________________________________ 4. The reason that my child(ren) is/are emancipated is as follows: ______________________________ has turned twenty-one (21) years of age. ______________________________ is at least eighteen (18) years of age; has not attended secondary or post-secondary school for the past four (4) months and is not enrolled in a secondary or post-secondary school; and is or is capable of supporting himself/herself through employment. ______________________________ has joined the United States armed services. Form #PS-31166-4 Approved by State Court Administration 05/09 Page 5 of 9 American LegalNet, Inc. www.FormsWorkFlow.com ______________________________ has married ______________________________ is not under the care or control of either parent or an individual or agency approved by the court. 5. The date upon which my child(ren) became emancipated was _________________. 6. My child support obligation should be terminated because of the emancipation of my child(ren), ____________________________________________________________. 7. The termination of my support obligation should be retroactive to the date(s) stated in Paragraph 5 above. 8. I therefore ask the Court to set this matter for a hearing. WHEREFORE, ______________________________ requests that this Court set this matter for hearing for the purpose of declaring my child(ren) emancipated, terminating my child support obligation, and order all other further relief that is just and proper in the premises. I affirm under the penalties of perjury that the foregoing representations are true. ___________________________________ Signature CERTIFICATE OF SERVICE I hereby certify that I sent a copy of this Petition by first class mail to the opposing attorney, or the opposing party if the opposing party is not represented by an attorney, on _________________. ___________________________________ Signature Form #PS-31166-4 Approved by State Court Administration 05/09 Page 6 of 9 American LegalNet, Inc. www.FormsWorkFlow.com