OFP301 State ENG Rev 7/15www.mncourts.gov/formsPage 1 of 2State Of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: Domestic Abuse Petitioner (first, middle, last) Respondent (first, middle, last)vs.In the Matter of:Affidavit and Order to Show Cause for Contempt (Minn. Stat. 518B.01)I, Petitioner Peace Officer Other interested party designated by the Courtdesignated by the Court) state that Respondent violated the following provisions of the Restraining Order dated . (List provisions of the Order that Respondent violated). These provisions were violated when Respondent committed the following acts (Describe specific acts including what happened, who was involved and approximate dates. List the most recent dates first. Add additional sheets if necessary.) Signature I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116.Dated: County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address:OrderTO: , the Respondent:Based on the Affidavit and all of the records and proceedings in this matter, YOU ARE ORDERED to appear at American LegalNet, Inc. www.FormsWorkFlow.com OFP301 State ENG Rev 7/15www.mncourts.gov/formsPage 2 of 2 (Address) on at .m.and explain why you should not be (Date) (Time)found in Contempt of Court for violating the Order for Protection dated .Note: All responsive pleadings shall be served and mailed to or filed with the court administrator no later than five days prior to the scheduled hearing. The Court may, in its discretion, disregard any responsive pleadings served or filed with the court administrator less than five days prior to such hearing in ruling on the motion or matter in question. If you do not appear, the court may hold you in contempt of court, and may issue a warrant for your arrest. Dated: Judge of District CourtNOTE: Bring witnesses and any supporting documentation to the hearing. Distribution Certified copy or original-Return to Court Administrator with Affidavit of Personal Service attached Copy for Petitioner(s) Copy for Respondent(s) Copy for file until original returned Copy for local police department Copy for Sheriff Other: Dissolution File American LegalNet, Inc. www.FormsWorkFlow.com