IN THE IOWA DISTRICT COURT FOR COUNTY (name of the county where you are filing this motion) : : : Civil No. Plaintiff, : (if you do not know, ask the clerk of court) (person who filed a Petition For : Relief From Domestic Abuse) : AFFIDAVIT TO START vs. : CONTEMPT PROCEEDINGS : BASED ON A CHAPTER 236 : PROTECTIVE ORDER : Defendant. : : Code ch. 236 The Court issued a Chapter 236 Temporary Protective Order or Protective Order in this case onthe day of , 02. I (plaintiff) believe the defendant has willfullyviolated that Order. I (plaintiff) swear under oath that the followin g is true and correct: (tell what thedefendant did that violated the Protective Order) I REQUEST THAT THE COURT issue a "Show Cause" Order which requires the defendant to appear before the Court and show the Court why he/she should not be h eld in contempt for not following the Protective Order; direct the sheriff to serve this Affidav it and Order to Show Cause.>>>> 2 I UNDERSTAND that I must attend the contempt hearing and tell the Court how and when the defendant disobeyed the Protective Order. In addition to my own testimo ny, I can bring other proof of the violation such as people who saw the defendant violate the order, pi ctures, medical records, police reports, or anything else that might help show the judge how the defenda nt violated the Protective Order. I UNDERSTAND that I may fill out and file this Affidavit by myself or with the help of a lawyer. (Please indicate) [ ] I am receiving no help from a lawyer. I am filing this Affidavit with assistance from: [ ] the County Attorney (Please specify name and address) [ ] another lawyer (Please specify name and address) STATE OF IOWA ) ) ss: COUNTY OF ) [name of county where Notary Public is located] PLAINTIFF [Sign only in front of a Notary Public]Subscribed and sworn to before me this day of , 02. Notary Public A booklet entitled "How to Protect Yourself from Domestic Abuse Without a Lawyer" is available at the clerk of courts office and from the nearest domestic abuse shelter. It explains court procedure and gives information about how to contact a lawyer. FOR OTHER GENERAL INFORMATION ABOUT DOMESTIC ABUSE, CALL THE (CONFIDENTIAL) IOWA DOMESTIC ABUSE HOTLINE: 1-800-942-0333 -2- [Affidavit To Start Contempt Proceedings Based on a Chapter 236 Protecti ve Order - IDOJ0793]