IN THE SUPERIOR COURT OF DEKALB COUNTY STATE OF GEORGIA Petitioner:___________________________________ Civil Action File No:_______________________ vs Respondent:_________________________________ PETITION FOR CITATION OF CONTEMPT NOW COMES _______________________________ (your full name), Petitioner in the above-styled action, and files this Petition for Citation of Contempt and shows the Court as follows: 1. County, Georgia as follows: An Order was entered in the Superior Court of The case name as it appeared in the prior action:_______________________________________________ Civil Action File Number (use the letter and number from that case):_______________________________ The date the Order was filed in the Court:____________________________________________________ A copy of that Order is attached. ' Respondent is subject to the jurisdiction of this Court (where Respondent lives in Georgia or can be personally served in Georgia) and may be personally served with a copy of this Petition and Rule Nisi at ____________________________________________________________________________________. ' Respondent is not a resident of DeKalb County. Respondent lives in _________________ County, Georgia and shall be served with a copy of this Petition and Rule Nisi by second original. ' Respondent is subject to the jurisdiction of this Court pursuant to the Georgia Domestic Relations Long Arm Statute (where Respondent is a non-resident of Georgia and you are seeking a contempt action against the opposing party for failure to pay child support/alimony, to obtain health/life insurance coverage, to pay medical expenses, to turn over property, or to pay other expenses) an may be personally served with a copy of this Petition and Rule Nisi at ________________________________ by second original. 2. 3. In the prior Order, Respondent was ordered: (check all that apply) ' to pay to Petitioner the amount of $____________ per ______________ per child in child support, and owes $___________to Petitioner as of the date of the filing of this Petition ' to allow Petitioner to visit with the minor child(Ren) but has refused to do so ' to give to Petitioner the following possessions but has refused to do so:________________________ __________________________________________________________________________________ __________________________________________________________________________________ " to pay for and have medical insurance for the minor child(ren) " to pay me back for medical bills in the amount of $ _________________________________________ " other: _____________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Petition for Citation of Contempt-rev. 4/01 2001 DeKalb County Superior Court Family Law Information Center Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 4. 5. Respondent was able to do what the Court ordered. Respondent's refusal to do so is willful. Respondent should be held in contempt of this Court's Order and confined to the common jail of DeKalb County until he/she purges him/herself of said contempt. Respondent should be ordered to reimburse Petitioner for payment of filing this action and cost of service. 6. WHEREFORE, Petitioner demands: 1. 2 3 4. 5. 6. 7. That process and summons issue as provided by law; That Respondent be served with a copy of Petitioner's Petition for Citation of Contempt; That Respondent be held in contempt for failure to obey the terms of the Court's Order; That a Rule Nisi hearing be set ordering Respondent to come to Court and tell the Judge why Petitioner's Petition should not be granted; That Respondent be ordered to reimburse Petitioner for the cost of filing and serving this action; That Petitioner be awarded any other relief this Court finds right and proper. This the ______________________ day of __________________, _________. [day] [month] [year] ________________________________________________________ (Sign your name here) Pro Se Petitioner's name (print or type):_______________________________ Petitioner's address:________________________________________ _________________________________________________________ Petitioner's telephone number:(___)____________________________ Petition for Citation of Contempt-rev. 4/01 2001 DeKalb County Family Law Information Center Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com