) ) SS: COUNTY OF HAMILTON ) __________________________________, Plaintiff(s) vs. __________________________________, __________________________________, Defendant(s). STATE OF INDIANA HAMILTON SUPERIOR COURT NO. 4 CAUSE NO. 29D04-________-SC-___________ VERIFIED MOTION FOR PROCEEDINGS SUPPLEMENTAL AND ORDER TO APPEAR Plaintiff states the following: that Plaintiff owns the judgment rendered in this cause against the Defendant(s); Plaintiff's judgment is unsatisfied; and Plaintiff has no cause to believe that levy of execution against the Defendant(s) will satisfy the judgment. Plaintiff therefore moves the Court to issue an order to Defendant(s) requiring the Defendant(s) to appear to testify concerning his/her/their property. I swear or affirm under the penalties for perjury that the foregoing representations are true. Dated: __________________, 201__ ________________________________________ Signature of Plaintiff or Attorney ORDER TO APPEAR IN COURT The Court grants the Plaintiff's motion. The Court ORDERS the Defendant(s) _____________________________________________________ to appear in this Court on the ____ day of ________________, 201__, at ____:____ a.m. and to bring evidence of income and assets. YOU ARE HEREBY NOTIFIED THAT FAILURE TO APPEAR IN COURT MAY RESULT IN YOUR BEING HELD IN CONTEMPT OF COURT AND BEING PUNISHED BY INCARCERATION IN THE COUNTY JAIL FOR A PERIOD NOT TO EXCEED 180 DAYS. Dated: ___________________, 201__ Certified Mail ________________________________________ Judge, Hamilton Superior Court 4 Sheriff of __________________ County Service requested: Address(es) of Defendant(s): _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ Distribution: ____ ____ Plaintiff(s) Defendant(s) (Sheriff's Return of Service on reverse side) American LegalNet, Inc. www.FormsWorkFlow.com SHERIFF'S RETURN OF SERVICE I hereby certify that on the below date: ____ ____ I served this Order to Appear by delivering a copy to the Defendant. I served this Order to Appear by leaving a copy: ____ ____ ____ at the dwelling or usual place of abode of Defendant; with a person of suitable age and discretion residing therein, namely _________________________________; and by mailing a copy of the Order to Appear to the Defendant, by first class mail, to the address listed on the Order to Appear (date copy mailed if different from below:__________________________, 200__). ____ I was unable to serve this Order to Appear because __________________________________________________ _________________________________________________________________________________________. Dated: ________________________, 201__. ________________________________________ Sheriff of Hamilton /________________ County By: _____________________________________ sc4form.085 (revised March 1. 2010) American LegalNet, Inc. www.FormsWorkFlow.com