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Affidavit Of Publication Form. This is a Indiana form and can be use in Family Law (Pro-Se) Statewide.
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Tags: Affidavit Of Publication, 4, Indiana Statewide, Family Law (Pro-Se)
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
Plaintiff(s)
-against-
Calendar No.
:
JUDICIAL SUBPOENA
:
:
:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
Instructions
result of your failure to comply.for filling out the Affidavit of Publication (Form #4)
Line #
Instructions
Witness, Honorable
, one of the Justices of the
1–8
Copy the title as it appears in the Appearance Form you filled out.
Court in
County,
day of
, 20
15
Print the name of the newspaper that is publishing your name change.
17
Print the city where this newspaper is located in the first blank and the
county name where this newspaper is located in the second blank.
19
Attorney(s) for
Print the month, date, and year of the first publication.
21
Print the month, date, and year of the second publication.
23
Office and publication.
Print the month, date, and year of the thirdP.O. Address
35 – 46
It is your responsibility to ask the newspaper representatives to fill out
Telephone No.:
these blanks.
STAD 6/12/02
(Attorney must sign above and type name below)
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..... ... ..
Form .Number 4
:
STATE OF INDIANA
COUNTY OF ______________
)
) SS:
)
Index No.
IN THE _____________ SUPERIOR/CIRCUIT COURT
:
Calendar No.
:
JUDICIAL SUBPOENA
CASE NO. ______________________________
Plaintiff(s)
-againstIN RE THE NAME CHANGE OF: )
)
___________________________ )
Petitioner.
:
:
:
AFFIDAVIT OF PUBLICATION
Defendant(s)
:
......................................................
I hereby certify that the Notice of Suit entitled “Petition for Change of Name,” was published three
(3) times, as prescribed by law, in the _________________________________, a newspaper in the City of
THE PEOPLE OF THE STATE OF NEW YORK
________________________, County of _________________________, Indiana, on the following dates:
TO
1. _______________________, 200__;
GREETINGS: 2. _______________________, 200__;
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
3. _______________________, 200__.
,
the Honorable
at the
Court
located at three said Notices, designated as First, Second, and Third Notice
CountyIof
further certify that copies of the
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or Suit, respectively,testify and give evidence as a witness in this action onhereto attached and made a part of
adjourned date, to and the publisher’s affidavit regarding same, are the part of the
of
this return.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
I on whose behalf this subpoena was issued for a maximum requirements applicable to such
the partyfurther certify that the newspaper aforesaid met all legalpenalty of $50 and all damages sustained as a
result of your failure to comply.
publication.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
_____________________________
, 20
Signature
37
38
_____________________________
(Attorney must sign above and type name below)
Print your name
39
40
41
42
_____________________________
Official Title
Attorney(s) for
_____________________________
Mailing address
43
44
45
46
47
_____________________________
Town, State and Zip and P.O. Address
Office Code
_____________________________
Telephone number, with area code
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
STAD 6/12/02
American LegalNet, Inc.
www.USCourtForms.com
