COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS CLERMONT COUNTY, OHIO ________________________________________ Plaintiff/Petitioner ________________________________________ Address ________________________________________ City ST ZIP Vs CASE NO. ______________________ JUDGE KATHLEEN M. RODENBERG MAGISTRATE ___________________ POST DECREE MOTION FOR CONTEMPT AND AFFIDAVIT ________________________________________ Defendant/Respondent ________________________________________ Address ________________________________________ City ST ZIP MOTION I, __________________________________, request an order for _____________________________ to appear and show cause why he/she should not be held in contempt for violating a court order and to find contempt for violating the court order regarding the following: (check all which apply) ____ ____ ____ ____ ____ interference with parenting time child support arrearage in the amount of $______________ You are required to bring to the hearing an updated printout from the CSE showing the amount of the child support arrearage. reimbursement of medical expenses incurred for the minor child/ren You are required to file with your Motion an Explanation of Medical Bills Form (available from the Court or on the Website). You are required to bring to the hearing (if not already filed): A. Copies of each bill for which you are seeking reimbursement B. Proof of payment by you. Proof of payment shall be limited to a receipt for payment signed by the medical provider, a copy of a cancelled check, or a copy of a credit card statement verifying the amount paid. failure to comply with the Court’s orders such as: ____ transfer of a car title ____ transfer of real estate ____ payment of debt ____ refinance of debt ____ distribution of personal property other: ________________________________________________________________________ Attorney fees and costs and any other relief as necessary and proper are also requested. ________________________________ Signature of Party NOTICE OF HEARING A hearing shall be held before Magistrate _________________ on the ______ day of _______________, 20_____, at _____________a.m./p.m., at the Court of Common Pleas, Division of Domestic Relations, Suite 200, 2340 Clermont Center Drive, Batavia, OH 45103. INSTRUCTIONS TO THE CLERK Please serve the above motion on ____________________________ at the following address: _____________________________________________________________________________ By ____ Certified Mail ____ Sheriff American LegalNet, Inc. www.FormsWorkFlow.com AFFIDAVIT Affiant states that the court order dated _______________________ has been violated as follows: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ I, ______________________, hereby swear and affirm the information set forth in this Affidavit is true, complete and accurate. ________________________________ AFFIANT SWORN to and SUBSCRIBED before me this __________ day of ___________________, 20______. ________________________________ NOTARY PUBLIC Rev. 6/11 Form DR-302 American LegalNet, Inc. www.FormsWorkFlow.com