Form Center

2. SUPERIOR COURT 3 OF TIPPECANOE COUNTY
4. Faith A. Graham, Judge
6. Tricia L. Thompson, Magistrate
8. Cause No.(s)*
10. Mother
12. First and Last Name:*
13. Date of Birth:*
    If unknown, please indicate
14. Telephone:*
    If unknown, please indicate
16. Address *
    If unknown, please indicate
17. City*
18. State*
20. Father
22. First and Last Name:*
23. Date of Birth*
    If unknown, please indicate
24. Telephone:*
    If unknown, please indicate
26. Address *
    If unknown, please indicate
27. City*
28. State*
30. Other
32. Name:
33. Date of Birth
34. Telephone:
36. Address (include city and zip)
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field