Circuit Court for Name Address City or County Case No. vs. Name Address City, State, Zip City, State, Zip Telephone Telephone Plaintiff Defendant PETITION FOR CONTEMPT (Denial of Visitation) (CC-DR-003) I, My Name , representing myself, state that: On the Circuit Court for issued an 1. Date City/County order in case number 2. , granting me visitation. Since then, I have been denied visitation with the child(ren) as ordered. The details of the denial(s) are: 3. 4. 5. I last visited with the child(ren) on Name Date . is now in contempt for failing to obey the Order. I do (Check One) do not want the court to order jail time to enforce its order. FOR THESE REASONS, I request the Court issue a Show Cause Order, find Name in contempt, enforce visitation, and order any other appropriate relief relating to visitation with the child(ren), including: Date Signature CC-DR-003 (Rev. 08/2016) American LegalNet, Inc. www.FormsWorkFlow.com