APPENDIX 17A SAMPLE ADMINISTRATIVE RULE 17 PETITION 

	Come now the Courts of __________ County and petition the Supreme Court for relief under Ind. Administrative Rule 17. In Support of this petition, the courts inform the Supreme Court as follows:

	1. The courts of __________ County have convened in banc and have determined: 

A. That of the fifteen (15) staff personnel, of all the courts combined, nine (9) are absent because of the __________ virus and are expected to be absent for up to four (4) weeks. 

B. That of the ten (10) clerk staff personnel, six (6) are absent because of virus and are expected to be absent for up to four (4) weeks. 

C. That three (3) of the five (5) judges are absent because of the virus and are expected to be absent for up to four (4) weeks. 

D. That the __________ County health department has declared a local health emergency, closed all local schools, banned all public gathering, and has issued quarantine orders. 

E. That the local courts have appointed Judge __________ as the presiding Judge for this emergency. 

	The judges of __________ County request that the Supreme Court declare that an emergency exists in __________ County under the authority of Ind. Admin. R. 17, and to make appropriate emergency orders for __________ County directing and allowing the courts and clerk of __________ County to alter, modify, and suspend necessary procedures as provided in the emergency plan submitted herewith, so as to appropriately address this emergency.

	DONE at Indianapolis, Indiana, this ___ day of __________, 20 ___.

								_________________________
								Judge