STATE OF INDIANA ) IN THE ) SS: ) CASE NO. COUNTY OF SUPERIOR/CIRCUIT COURT Petitioner, V. Respondent. TO: ORDER TO APPEAR AND NOTICE OF HEARING A Verified Motion for Contempt has been filed in this Court in this case. IT IS THEREFORE ORDERED by the Court that ______________________________, who ________ at ___________________________________________________________________________________, IS ORDERED TO APPEAR in the __________________ Superior/Circuit Court, located at __________________________________________________________________________________, Indiana, on the _____ day of ________________, 20_____, at ________, ___.m., to explain why such person should not be punished for contempt of this Court’s Order. Failure to appear if properly served may result in a warrant for your arrest. Dated: _____________________ Page 1 of 2 ___________________________________ Judge Form PS-34473-2 Approved by State Court Administration 12/10 American LegalNet, Inc. www.FormsWorkFlow.com CLERK’S CERTIFICATE OF MAILING I certify that on the ____ day of ______________, 20___, I mailed a copy of this Motion for Contempt to the Defendant by certified mail requesting a return receipt. DATED this ____day of _____________, 20___. ______________________________ CLERK CLERK’S RETURN OF SERVICE ACCEPTED BY MAIL I hereby certify that service of this Motion for Contempt with return receipt requested was mailed and that a copy of the return receipt was received by defendant the ____ day of ____________, 20___, which copy is attached. DATED this ____day of __________, 20____. ______________________________ CLERK CLERK’S CERTIFICATE OF SERVICE NOT ACCEPTED BY MAIL I hereby certify that I mailed a copy of this Motion for Contempt to the Defendant by certified mail, and the same was returned without acceptance this ____ day of _______________, 20___. DATED this ____day of ___________, 20____. ______________________________ CLERK SHERIFF’S RETURN OF SERVICE This Motion for Contempt came to hand on the ____ day of ____________, 20____, and I served the same on the _____day of ____________, 20____: 1.____By delivering a copy of the Motion for Contempt personally to the Defendant. 2.____By leaving a copy of the Motion for Contempt at the dwelling or usual place of abode of the Defendant; and mailing a copy of the Motion for Contempt to the Defendant at the Defendant’s last known address. 3.____By serving Defendant’s agent as provided by rule statute or valid agreement, and mailing a copy of this Motion for Contempt to Defendant at Defendant’s last known address. 4.____Defendant cannot be found in my bailiwick, and this Motion for Contempt was not served. AND I NOW RETURN THIS __________________ THIS _____day___________, 20____. ______________________________ SHERIFF Page 2 of 2 Form PS-34473-2 Approved by State Court Administration 12/10 American LegalNet, Inc. www.FormsWorkFlow.com