STATE OF SOUTH CAROLINA COUNTY OF ________________________________ Plaintiff, vs. Defendant. ) ) ) ) ) ) ) ) ) ) ) IN THE FAMILY COURT _____JUDICIAL CIRCUIT RULE TO SHOW CAUSE AND AFFIDAVIT (Contempt of Court by Payor) Docket No. ______________________________________ In Re:__________________________________, Employer Address: ________________________________ ________________________________ RULE TO SHOW CAUSE To Employer listed above: It appears that you have not complied with the requirements of the Notice to Withhold as described below. Therefore, IT IS ORDERED THAT YOU APPEAR BEFORE THE FAMILY COURT at__________________________________, on ( / / ), at____:____, ( a.m/ p.m.), and be prepared to show cause why you should not be held in contempt of court for the allegations stated below: Date: ______________________, 20____ ________________________, S.C. ___________________________________ Family Court Judge AFFIDAVIT ________________________ (Clerk of Court) states under oath that (s)he is the custodian of Court records for __________________________ County, and respectfully alleges and shows: 1. 2. This Court has jurisdiction of the parties and the subject matter; The Employer was notified by the Clerk of Court on ( / / ) regarding the following requirements and has failed and refused to comply with one or both of the requirements of the Notice to Withhold, pursuant to S.C. Code Ann. § 63-17-1410, et seq., as amended: To withhold the sum of $ __________________ per _____________ from the wages of the Defendant; and/or To notify the Clerk's Office if health insurance is available to the Defendant for the benefit of the child(ren) for whom child support is being withheld. The Employer has willfully refused to comply with the Notice to Withhold and: The Employer should appear before the Court to show cause why it should not be held in contempt. A judgment should be entered and execution issued against the Employer for the total amount the Employer has willfully failed to withhold. The Employer is subject to a civil fine not to exceed five hundred dollars which may be imposed by the court in its discretion. 3. Sworn to before me this Day of __________________, 20 ___ (Deputy) Clerk of Court _________________________________ Notary Public for South Carolina My Commission Expires: ____________ Custodial Parent (if applicable): __________________________________________________________________________ SCCA 445 (4/2010) American LegalNet, Inc. www.FormsWorkFlow.com