Small Claims Court _________________________ County, Colorado Court Address: PLAINTIFF(S): ______________________________________________ Address: ____________________________________________________ City/State/Zip: ________________________________________________ Phone: Home _______________________ Work ___________________ v. DEFENDANT(S): _____________________________________________ Address: ____________________________________________________ COURT USE ONLY Case Number: __________________ City/State/Zip: ________________________________________________ Phone: Home _______________________ Work ___________________ Division ______ Courtroom _______ NOTICE OF NON-COMPLIANCE AND ORDER Please take notice that _____________________________________ (name of party) has failed to comply with the terms of the order to compel delivery, compliance, or performance that was entered by the Court on ______________________________ (date) in the following manner: I request that the Court schedule a hearing to determine the amount of damages or other remedies to be imposed for the failure to comply with the judgment. _____________________________________ Signature Date: ________________________________ CERTIFICATE OF MAILING I hereby certify that on __________________________ (date), I mailed a true and correct copy of the NOTICE OF NON-COMPLIANCE AND ORDER, by placing it in the United States Mail, postage pre-paid to the parties at the addresses listed above. ______________________________________________ Clerk of the Court/Deputy ORDER A hearing is set for __________________________ (date) to determine the amount of damages or other remedies to be imposed by the Court for the failure to comply with the judgment. Failure to appear may result in an imposition of damages or other remedies allowed by law. Dated: ____________________________ _____________________________________ Judge Magistrate JDF 249 R1/07 NOTICE OF NON-COMPLIANCE AND ORDER American LegalNet, Inc. www.FormsWorkflow.com