COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION CLERMONT COUNTY, OHIO Case Number: Plaintiff/PetitionerAddress City State ZIP vs/and Post Decree Motion for Contempt And Affidavit in Support Defendant/Petitioner Address City State 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 Interference with parenting time (be specific): Failure to pay (child support)/(spousal support) according to the order filed on , the total child/spousal support arrearage is $ . ** The party filing this motion is required to bring to the hearing an updated printout Reimbursement of medical expenses incurred for the minor child/ren. ** The party filing this motion is required to bring to the hearing: A. Copies of each bill for which you are seeking reimbursement B. Proof of your payment limited to a receipt for payment signed by the medical provider, Failure to comply with the Court222s orders such as: transfer of a car title transfer of real estate payment of debt (be specific): . . distribution of personal property (be specific): other (be specific) . Am Attorney fees and costs and any other relief as necessary and proper are also requested. Email address Phone Number Your Signature AFFIDAVIT (DO NOT SIGN UNTIL NOTARY IS PRESENT) I, , hereby swear or affirm that I have read this document an, to the best of my knowledge and belief, the facts and information stated in this document are true, accurate and complete. I understand that if I do not tell the truth, I may be subject to penalties for perjury. AFFIANT SWORN to and SUBSCRIBED before me this day of , 20 . NOTARY PUBLIC 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, 2340 Clermont Center Drive, Suite 200, Batavia, Ohio 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