STATE OF INDIANA COUNTY OF (Select One) ) IN THE (Select One) ) SS: ) CASE NO. SUPERIOR/CIRCUIT COURT IN RE THE (Select One) OF: Petitioner, V. Respondent. TO: ORDER TO APPEAR AND NOTICE OF HEARING A Verified Motion for Contempt Regarding Parenting Time (Visitation) Order has been filed in this Court in this case. IT IS THEREFORE ORDERED by the Court that __________________________________, who (Select Onat ________ ___________________________________________________________________________________, IS ORDERED TO APPEAR in the (Select One) __________________ 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 Parenting Time (Visitation) Order. Failure to appear if properly served may result in a warrant for your arrest. Dated: _____________________ ______________________________ Judge Form #PS-31174-1 Approved by State Court Administration 02/10 Page 7 of 8 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 Form #PS-31174-1 Approved by State Court Administration 02/10 Page 8 of 8 American LegalNet, Inc. www.FormsWorkFlow.com