Verified Petition for Dissolution of Marriage - Indiana - Edit, Fill, Sign Online

Please answer the questions below.

When you answer the questions, they will automatically fill in that information where it belongs on the

following forms that you will be filing with the court. Do not leave any questions blank. Any changes

you make must be made to these questions; you will not be able to modify your answers in the forms

themselves. Please have all of your information handy when you are answering these questions.

1. What is the name of the County where you will be filing this divorce? ________________________

2. What is your full name?

____________________________________________________________

3. What is your street address?

____________________________________________________________

4. What is your town, state, and ZIP Code?

____________________________________________________________

5. What is your telephone number, with area code? ______________________

6. What is your email address? _________________________________

7. If you have a fax machine number and want to receive service by fax machine, what is your fax machine

number, with area code? ______________________

8. If you have used the Attorney General Confidental address in any related cases, select “X”: _____

9. What is your spouse’s full name?

____________________________________________________________

10. What is your spouse’s street address?

____________________________________________________________

11. What is your spouse’s town, state and ZIP Code?

____________________________________________________________

12. Are there are other Court cases involving yourself and the other party? _____ Yes _____ No

13. If you selected “Yes,” for each case you and the other party are involved, what is the name of the Court and

Case Number. If you selected “No,” skip to the next question.

Caption:____________________________ Case Number: ________________________

14. What is the date that you and your spouse were married? ____________________

15. What is the date that you and your spouse were separated? ____________________

16. Type the name of the person (either you or your spouse) who has lived in the county you will be filing your

divorce in for at least the last three months and who has lived in the state of Indiana for at least the last six

months.

____________________________________________________________

17. There _________ real estate

18. Are there debts and property that need to be divided? Yes No

If “yes,” list them individually below:

a. _________________________________________________________________

b. _________________________________________________________________

c. _________________________________________________________________

d. _________________________________________________________________

19. Does the wife want her former name restored? Yes No

If “yes,” what is the former name she wishes to have restored?

____________________________________________________________

20. Do you need the Judge to issue any provisional orders? Yes No

Provisional orders are temporary orders that will be in effect while you are waiting for your final hearing. If

you answered “No” to this question, go on to Question 18 and do not file the Notice of Provisional Hearing or

the Temporary Order with the court. You should contact an attorney or consult a legal dictionary if you do not

understand these terms. A separate case is required for a Protective Order involving Domestic Violence, and

you must file it as a separate case. If you are seeking a Protective Order, you may obtain a form from the Clerk

of the Court or obtain it from the Indiana Judicial Center’s website at

http://www.in.gov/judiciary/forms/po.html.

Temporary possession of the marital

residence;

Temporary division of debts;

Temporary division of property;

Spousal maintenance;

Restraining the parties from transferring,

encumbering, concealing, or in any way

disposing of any of the property of the part;

Other: Explain

____________________________________

21. For service of this divorce packet, how do you want your spouse to be served? Please note, there is an

additional charge for service by Sheriff. You will need to talk to the Clerk to find the amount you will be

charged.

I want my spouse served by Certified Mail

I want my spouse served by Sheriff at their home address

I want my spouse served by Sheriff at their job, their employer name and address is:

________________________________________________________________________

You have finished answering the questions. The following pages are the forms that you will be

printing and then filing with the court. Please look over them to make sure the information is correct

before you print them out. If you have changes, you must make them to the questions above. Once

you have printed this packet, make sure you sign it on the Signature line. Your signature must be on

these forms before you make copies and file it with the court.

Page 1 of 2 Form TCM-TR3.1-2

Revised by State Court Administration 10/10

STATE OF INDIANA ) IN THE SUPERIOR/CIRCUIT COURT

) SS:

COUNTY OF ) 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 [email protected].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 2 of 2 Form TCM-TR3.1-2

Revised by State Court Administration 10/10

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.

______ Yes X No

6. There are related cases: Yes____ No ____ (If yes, please indicate below.)

Caption and case number of related cases:

Caption:____________________________ Case Number: ________________________

7. Additional information required by local rule:

_________________________________________________________________________

____________________________________

Self-Represented Party

Page 1 of 2 Form PS-31152-12

Revised by State Court Administration 10/10

STATE OF INDIANA ) IN THE SUPERIOR/CIRCUIT COURT

) SS:

COUNTY OF ) CASE NO.

IN RE THE MARRIAGE OF:

Petitioner,

V.

Respondent.

VERIFIED PETITION FOR DISSOLUTION OF MARRIAGE

(AND REQUEST FOR PROVISIONAL ORDERS)

The Petitioner, ____________________________________________________________, now states:

1. Petitioner and Respondent were married on _________________, and separated on

_________________.

2. ___________________________________________________________ has been a continuous

resident of ________________ County for the last 3 months.

3. ___________________________________________________________ has been a continuous

resident of the State of Indiana for the last 6 months.

4. There are no children of the marriage and the Wife is not pregnant.

5. Debts and property:

There _______ real estate

There are no debts / personal property to divide.

Petitioner wishes the Court to divide the following debts / personal property:

a. _________________________________________________________________

b. _________________________________________________________________

c. _________________________________________________________________

d. _________________________________________________________________

6. Neither party is a member of the military.

7. This marriage has suffered an irretrievable breakdown and should be dissolved.

Page 2 of 2 Form PS-31152-12

Revised by State Court Administration 10/10

8. Change of name:

Wife would like her former name of

____________________________________________________________ restored to her.

Wife does not want to change her name.

I request that this Court issue its order dissolving the marriage of the parties, and for all other just

and proper relief and until this matter is finalized, I request the following provisional orders:

I do not request any provisional orders;

Temporary possession of the marital residence;

Temporary division of debts;

Temporary division of property;

Spousal maintenance;

Restraining the parties from transferring, encumbering, concealing, or in any way disposing

of any of the property of the part;

Other: ___________________________________________________________

I affirm under the penalties of perjury that the foregoing representations are true.

_____________________________________

Signature

Page 1 of 1 Form PS-31152-5

Revised by State Court Administration 10/10

STATE OF INDIANA ) IN THE SUPERIOR/CIRCUIT COURT

) SS:

COUNTY OF ) CASE NO.

IN RE THE MARRIAGE OF:

Petitioner,

V.

Respondent.

NOTICE OF PROVISIONAL HEARING

A Verified Petition for Dissolution of Marriage and Request for Provisional Orders has been

filed in this Court. The Court now sets this matter for a Provisional Hearing on _________________ at

___________ A.M./P.M. The Parties may present evidence on their behalf. Failure to appear may

result in matters being decided in your absence.

So ordered this ______day of ________________________, 20____.

_____________________________ _____________________________________

Date Judge

Distribution:

Page 1 of 3 Form PS-31152-6

Revised by State Court Administration 10/10

STATE OF INDIANA ) IN THE SUPERIOR/CIRCUIT COURT

) SS:

COUNTY OF ) CASE NO.

IN RE THE MARRIAGE OF:

Petitioner,

V.

Respondent.

TEMPORARY ORDER

Petitioner appears/does not appear, and Respondent appears/does not appear for provisional

hearing on ______________________, 20___. The court having been duly advised in this matter, now

finds the following:

______ Petitioner/Respondent is awarded temporary custody of the minor child(ren);

______ Petitioner/Respondent shall pay temporary child support for the minor child(ren)

in the amount of $__________________ per week, payable through the

______________ County Clerk, or by income withholding order if available from

the employer, beginning on ________________________, 20____.

______ Petitioner/Respondent shall be responsible for the first $__________________ of

uninsured medical expenses for the minor child(ren). Thereafter, Petitioner shall

be responsible for ________% and Respondent for ________% of uninsured

medical expenses for the minor child(ren).

______ Petitioner/Respondent shall have temporary parenting time (visitation) with the

minor child(ren) as the parties agree or according to the Indiana Parenting Time

(Visitation) guidelines;

______ Petitioner/respondent shall have temporary possession of the marital residence;

______ Petitioner/Respondent shall temporarily maintain medical, dental, and optical

insurance as available through employment for the following persons:

__________________________________________

Page 2 of 3 Form PS-31152-6

Revised by State Court Administration 10/10

______ There shall be a temporary division of debts, as follows:

a. Petitioner shall be solely responsible for the following debts:

________________________________________________

b. Respondent shall be solely responsible for the following debts:

_________________________________________________

_______ There shall be a temporary division of property, as follows:

a. Petitioner shall have sole possession of the following items of property:

__________________________________________________

b. Respondent shall have sole possession of the following items of property:

__________________________________________________

_______ There shall be a temporary division of motor vehicles, as follows:

a. Petitioner shall have temporary possession of the following vehicles:

__________________________________________________

(Vehicle #1, Make, Model, and Year)

__________________________________________________

(Vehicle #2, Make, Model and Year)

b. Respondent shall have temporary possession of the following vehicles:

__________________________________________________

(Vehicle #1, Make, Model, and Year)

__________________________________________________

(Vehicle #2, Make, Model and Year)

_______ There shall be a temporary restraining order in effect during these proceedings:

______ Restraining the parties from removing the child(ren) from the state

without the permission of the court or all parties;

Page 3 of 3 Form PS-31152-6

Revised by State Court Administration 10/10

______ Restraining the parties from transferring, encumbering, or

concealing, or in any way disposing of any of the property of the

parties;

______ Other:

_____________________________________________

ALL OF WHICH IS SO ORDERED THIS______ DAY OF __________________,

20____.

________________________ _____________________________

Date Judge

Distribution:

Fillable Printable Verified Petition for Dissolution of Marriage - Indiana

Fillable Printable Verified Petition for Dissolution of Marriage - Indiana

Verified Petition for Dissolution of Marriage - Indiana