Civil Appearance Form {TCM-TR3.1-4}

NOT FOR PUBLIC ACCESS IN ACCORDANCE WITH ADMINISTRATIVE RULE 9 Special Instructions: This page must be on separate, light green paper. See bottom of page for text of Trial Rule 5(G)(2). ) ) SS: COUNTY OF____________ ) STATE OF INDIANA IN THE ___________________________ COURT Case Number: (Caption) CIVIL APPEARANCE FORM Item 5 (Social Security numbers of all family members in cases involving support): Name: _________________________________ Name: _________________________________ Name: _________________________________ Name: _________________________________ Name: _________________________________ Name: _________________________________ Name: _________________________________ Name: _________________________________ SS # SS # SS # SS # SS # SS # SS # SS # _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ Item 8 (Social Security number of person who is subject to involuntary commitment): Name: _________________________________ SS # _________________________ When only a portion of a document contains information excluded from public access pursuant to Administrative Rule 9(G)(1), said information shall be omitted [or redacted] from the filed document and set forth on a separate accompanying document on light green paper conspicuously marked "Not For Public Access" and clearly designating [or identifying] the caption and number of the case and the document and location within the document to which the redacted material pertains. NOT FOR PUBLIC ACCESS Form TCM-TR3.1-4 Revised by State Court Administration 07/09 American LegalNet, Inc. www.FormsWorkFlow.com