APPEARANCE BY A SELF-REPRESENTED LITIGANT IN A CIVIL CASE

(Not For Use in a Protective Order (PO) Case)

STATE OF INDIANA

DELAWARE COUNTY

SS:

IN THE DELAWARE CIRCUIT

COURT NO.

Petitioner/Plaintiff
vs
Respondent/Defendant
CAUSE NO. 18C0
1. My Name:
2. My Address:
3. My telephone number:
4. My fax number:
5. My e-mail address:
6. I will accept service from other parties by:
FAX at the above noted number:
Yes
No
Email at the above noted address:
Yes
No
7. This case involves child support issues:
Yes
No

(If yes, supply Social Security Numbers for all family members on a separately Attached document filed as confidential information on light green paper. Use Form TCM-TR3.1-5.)