Appendix K: Request for Case Status Update
STATE OF INDIANA	)	____________________________ COURT 
	) SS:
COUNTY OF _____________	)	CAUSE NO. _________________________

	)
Plaintiff,	)
vs.	)
	)
Defendant.	)
REQUEST FOR CASE STATUS AND UPDATES
Please answer these questions to assist the court when it can begin conducting proceedings on evictions after the moratorium is lifted.  Return the completed form to the Court within 10 days. Information regarding evictions and resources is available at: https://www.in.gov/judiciary/5758.htm. 
Does your case involve non-payment of rent for a CARES Act covered property, federally- subsidized housing, or federally-backed mortgage (See: Notice of CARES Act covered properties for information)?
[   ]  Yes		[   ]  No
Does your case still require a hearing on possession of the premises?  
[   ]  No   Will you be filing a motion to dismiss your case or do you need a hearing on damages?
[  ]   Will file Motion to Dismiss		[  ]   Hearing on Damages  
Please provide an updated address for the tenant: ________________________________________________________________________
[   ]  Yes   Does the breach of the lease agreement involve nonpayment of rent?
[   ]  No   Please describe the alleged breach:__________________________________________
______________________________________________________________________________
[   ]  Yes   How many days has there been a nonpayment? (circle one)   120+    90 +   60 +
A possession hearing may be by video or phone, provide updated email addresses and phone numbers for the parties: 
Plaintiff/Landlord:________________________________________________________________
Defendant(s)/Tenant(s):___________________________________________________________
Has either party attempted to obtain assistance with payments for some or all of the rent due?  
[     ]   No	[     ]   Yes  From which program: ________________________	[     ]   Unsure
What is the status of the request for rental assistance? _________________________________
Have any payments been made on this claim since it was filed?
[     ]   No	[     ]   Yes   How much has been paid? ______________ 
I affirm, under the penalties for perjury, that the foregoing representation is true to the best of my knowledge and belief.
______________________	___________________________________
Date	Signature
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	Printed