MOTION AND NOTICE AND JUDGMENT FOR ARREARAGES Commonwealth of Virginia Va. Code §16.1-278.18 Case No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . & Domestic Relations District Court . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Juvenile ....................................................................................................................................... STREET ADDRESS OF COURT ...................................................... DEFENDANT .................................................................... PETITIONER v. ...................................................... ADDRESS/LOCATION .................................................................... ADDRESS/LOCATION ...................................................... ADDRESS/LOCATION .................................................................... .................................................................... TELEPHONE NUMBER ...................................................... ...................................................... TELEPHONE NUMBER The undersigned respectfully represents to the Court that the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . did NAME OF COURT AWARDING SUPPORT on . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . enter DATE AMOUNT OF PAYMENT AND TERMS OF PAYMENT judgment and order the defendant to pay to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .for NAME OF PAYEE the support of ....................................................................................................................................... NAME(S) OF DEPENDENT(S) ....................................................................................................................................... The undersigned states that the defendant has not paid all of the support money ordered by the Court, leaving a balance due of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., which amount is equal to or greater than. . . . . . . . . . . . . . . . . . BALANCE DUE NO. OF MONTHS DATE months of support payments owed as of ........................................................ Wherefore, the undersigned moves the Court to enter judgment against the defendant on . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . for the balance due shown above plus any other further delinquent payments as of the date of judgment. ................................... DATE __________________________________________ PETITIONER ............................................................... CASE DISPOSITION JUDGMENT that Petitioner(s) recover against Defendant the sum of $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . with interest; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . until paid, INTEREST RATE AND DATE FROM WHICH INTEREST IS DUE $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . costs, and $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . attorney's fees. COSTS ATTY. FEE JUDGMENT FOR DEFENDANT NON-SUIT DISMISSED Defendant(s) present? yes no .......................................................... _________________________________________ JUDGE American LegalNet, Inc. www.FormsWorkflow.com DATE ENTERED FORM DC-625 (MASTER, PAGE ONE OF TWO) 7/05 Case No. .................................................................................... NOTICE TO THE DEFENDANT: You are hereby notified that the party who filed this motion will move this Juvenile and Domestic Relations District Court on ................................................................................................ DATE AND TIME . to enter judgment against you in the amount of money alleged to be unpaid. ..................................................................................... DATE ___________________________________________ CLERK SERVICE OF PROCESS ON DEFENDANT Personal service Being unable to make personal service, a copy was delivered in the following manner: Delivered to family member (not temporary sojourner or guest) age 16 or older at usual place of abode of party named above after giving information of its purpose. (List name, ages of recipient and relation to party named above.) Posted on front door or such other door as appears to be the main entrance of usual place of abode, address listed above. (Other authorized recipient not found.) Delivered to ................................................................................................................................................................................................. the residence. business address of record. Not found .......................................................................................... DATE __________________________________________ SERVING OFFICER for ________________________________________ FORM DC-625 (MASTER, PAGE TWO OF TWO) 6/06 American LegalNet, Inc. www.FormsWorkflow.com