IN THE JUVENILE COURT OF MEMPHIS AND SHELBY COUNTY, TENNESSEE Petitioner V. Docket Number Defendant PETITION FOR CITATION FOR CONTEMPT OF COURT Your petitioner respectfully represents: That on the day of , 20 , an order of support was entered in this cause awarding petitioner for the support of the minor child(ren) of the parties. That the defendant is able-bodied, capable of earning adequate funds with which to comply with the orders of this Court, and that said defendant has willfully failed or refused to pay support as ordered by the Court. PREMISES CONSIDERED, PETITIONER PRAYS: 1. That defendant be cited to show cause for failure to comply with the orders of this Court. 2. That the Court make a determination as to the total amount of child support arrearage and the amount of payments the defendant should make toward reducing the arrearage. 3. That such and further relief be granted to which petitioner may be entitled in the premises. Petitioner STATE OF TENNESSEE COUNTY OF SHELBY AFFIDAVIT Affiant, an Assistant Attorney General for the Fifteenth Judicial Circuit of Tennessee, makes oath that in this capacity, Affiant is the attorney for the petitioner in the foregoing petition and personally knows that the statements in said petition are true except those made on the information and belief of petitioner, and those believed to be true, all to the best information, knowledge and belief of said Assistant Attorney General. Assistant Attorney General Sworn to and subscribed before me this day of , 20 JANIS FULLILOVE, Clerk of Court FIAT By D. C. To the Clerk of the Juvenile Court of Memphis and Shelby County, Tennessee: File the foregoing petition and issue the scire facias as prayed for therein requiring the defendant to appear on the day of , 20 , at o'clock M. and show cause why the defendant should not be adjudged in contempt of Court and punished accordingly. This day of , 20 Juvenile Court Judge JC-047A American LegalNet, Inc. www.FormsWorkFlow.com