STATE OF INDIANA COUNTY OF _______________ ) IN THE _______________ SUPERIOR/CIRCUIT COURT ) SS: ) CASE NO. ______________________________ IN RE THE MARRIAGE OF: ______________________________ Petitioner, V. ______________________________ Respondent. 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) X ; Responding (answering or defending)_____; or Intervening ____; in this case and am representing myself. 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-TR3.1-2 Revised by State Court Administration 10/10 American LegalNet, Inc. www.FormsWorkFlow.com 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. X 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-TR3.1-2 Revised by State Court Administration 10/10 American LegalNet, Inc. www.FormsWorkFlow.com