Indiana Form Appearance – Fill Out and Use This PDF

STATE OF INDIANA	)	IN THE ___________________________ COURT
	) SS:
COUNTY OF________	)	Case Number:
		(To be supplied by Clerk when case is filed.)
(Caption)

APPEARANCE BY ATTORNEY IN CIVIL CASE This Appearance Form must be filed on behalf of every party in a civil case.

1. The party on whose behalf this form is being filed is:

Initiating ____

Responding ____

Intervening ____ ; and

the undersigned attorney and all attorneys listed on this form now appear in this case for the following parties:

Name of party___________________________________________________

Address of party (see Question # 6 below if this case involves a protection from abuse order, a workplace violence restraining order, or a no-contact order)

_______________________________________________________________________

_______________________________________________________________________

Telephone # of party _____________________________________

(List on a continuation page additional parties this attorney represents in this case.)

2.Attorney information for service as required by Trial Rule 5(B)(2)

Name: ____________________________ Atty Number: __________________

Address: ___________________________________________________________

___________________________________________________________________

Phone: _____________________________________________________________

FAX: ______________________________________________________________

Email Address: ______________________________________________________

(List on continuation page additional attorneys appearing for above party)

3.This is a __________ case type as defined in administrative Rule 8(B)(3).

4.I will accept service by:

FAX at the above noted number: Yes ____ No ____

Page 1 of 3	Form TCM-TR3.1-1 Revised by
	State Court Administration 07/09

Email at the above noted number: Yes ____ No ____

5.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-TR3.1-4.)

6.This case involves a protection from abuse order, a workplace violence restraining order, or a no – contact order. Yes ____ No ____ (If Yes, the initiating party must provide an address for the purpose of legal service but that address should not be one that exposes the whereabouts of a petitioner.) The party shall use the following address for purposes of legal service:

________	Attorney’s address
________	The Attorney General Confidentiality program address
	(contact the Attorney General at 1-800-321-1907 or e-mail address is
	confidential@atg.state.in.us).
________	Another address (provide)

______________________________________________________________

7.This case involves a petition for involuntary commitment. Yes ____ No ____

8.If Yes above, provide the following regarding the individual subject to the petition for involuntary commitment:

a.Name of the individual subject to the petition for involuntary commitment if it is not already provided in #1 above: ____________________________________________

b.State of Residence of person subject to petition: _______________

c.At least one of the following pieces of identifying information:

(i)Date of Birth ___________

(ii)Driver’s License Number ______________________

State where issued _____________ Expiration date __________

(iii)State ID number ____________________________

State where issued _____________ Expiration date ___________

(iv)FBI number __________________________

(v)Indiana Department of Corrections Number _______________________

(vi)Social Security Number is available and is being provided in an attached confidential document Yes ____ No ____

9.There are related cases: Yes ____ No ____ (If yes, list on continuation page.)

10.Additional information required by local rule:

_____________________________________________________________________

Page 2 of 3	Form TCM-TR3.1-1 Revised by
	State Court Administration 07/09