STATE OF INDIANA COUNTY OF ) IN THE ) SS: ) CASE NO. SUPERIOR/CIRCUIT COURT Petitioner, V. Respondent. VERIFIED MOTION FOR CONTEMPT Comes now ______________________________, and states that on ________________, this Court entered an order whereby ______________________________, was ordered to ________ the following: Since the date of such order, such person has violated the above order in that WHEREFORE, the undersigned asks that the Court order ______________________________ TO APPEAR in open Court and explain why such person should not be punished for contempt of Court. I affirm under the penalties for perjury that the foregoing representations are true. ___________________________________ Signature CERTIFICATE OF SERVICE I hereby certify that I sent a copy of this Motion by first class mail to the opposing attorney, or the opposing party if the opposing party is not represented by an attorney, on _________________. ___________________________________ Signature Page 1 of 1 Form PS-34473-1 Approved by State Court Administration 12/10 American LegalNet, Inc. www.FormsWorkFlow.com