Form DC-481 SHOW CAUSE SUMMONS (CIVIL) SHOW CAUSE SUMMONS (CIVIL) VA. CODE §§ 8.01-508, 8.01-519, 8.01-564, 8.01-565, 16.1-69.24, 19.2-358 Commonwealth of Virginia [ ] General District Court 1 ............................................................................................................. [ ] Juvenile and Domestic Relations District Court Page: 2 CASE NO. HEARING DATE AND TIME 14 SUMMON THIS RESPONDENT: CITY OR COUNTY ......................... 2 ....................................................................................................................................................................................................................... STREET ADDRESS OF COURT TO ANY AUTHORIZED OFFICER: You are hereby commanded to summons forthwith the Respondent to appear before this Court on 3 ........................................................................ to show cause, if any, why Respondent should not, pursuant to 15 ........................................................................................................... LAST NAME, FIRST NAME, MIDDLE NAME ......................... ........................................................................................................... ........................................................................................................... ......................... ......................... ......................... DATE AND TIME 4 Virginia Code § ........................................................................... COMPLETE DATA BELOW IF KNOWN BORN RACE SEX 5 [ ] have judgment in the amount of $ ......................................................... or other such amount as may be proved MO 6 [ ] be imprisoned until the Respondent complies with the Court’s order or be fined for: DAY HT YR FT 8 [ ] failure to provide support as ordered on on EYES HAIR ......................... ......................... ......................... 17 ......................... ......................................................................................... ................................................................................................................... DATE ......................... SSN 7 [ ] failure to pay fines, costs, forfeiture, restitution and/or penalty or an installment there thereof: ................................................................... WGT IN 16 entered against the Respondent Garnishee. payment due: $ 21 ......................... ......................... SHOW CAUSE SUMMONS (CIVIL) ......................... ......................... $ .................................................................... per ................................................................................................................... ......................... with $ ......................................................... arrearage as of 9 [ ] failure to obey and order of [ ] this court [ ] dated ......................................... ordering ........................................................................................... .......................................................................................................................... 10 [ ] failure to appear on .................................................................... to answer interrogatories DATE 11 [ ] (Other-Explain) ................................................................................................................................................................... .................................................................................................................................................................................................... .................................................................................................................................................................................................... [ ] CONTINUED ON REVERSE WARNING: Failure to appear may result in your being fined or jailed. 12 ............................................................... DATED ISSUED In connection with the case of ......................... ..................................................................................................... 13 _________________________________________________________________ [ ] CLERK [ ] MAGISTRATE [ ] Commonwealth of Virginia 18 [ ] .................................................................................................... ......................... ......................... ......................... ............................................................................................................. ......................... v./In re ......................... 19 ............................................................................................................. ......................... ............................................................................................................. ......................... 20 UNDERLYING CASE NO. ........................................................ ......................... ......................... [ ] JUDGE FORM DC-481 (FRONT) 10/06 DISTRICT COURT MANUAL American LegalNet, Inc. www.FormsWorkFlow.com FORMS VOLUME DECEMBER 2007 Form DC-481 SHOW CAUSE SUMMONS (CIVIL) Page: 3 Data Elements, front 1. Court name. Check box for type of court. 2. Address of court. 3. Hearing date and time. 4. Applicable code section. 5. Judgment amount requested. 6. Check if imprisonment is requested. 7. Check if requesting imprisonment for failure to make payment. 8. Check if requesting imprisonment for failure to provide support. 9. Check if requesting imprisonment for failure to obey a court order. Check box to indicate which court issued the order. 10. Check if requesting imprisonment for failure to appear to answer interrogatories. 11. Check if there is another reason for requesting the Show Cause Summons. Explain the reason, using reverse of form if more space is necessary. 12. Date issued. 13. Signature and title of issuer. 14. Court case number. 15. Name of respondent. 16. Fill in physical characteristics of respondent, if known. 17. Social security number of respondent. 18. Check box if suit is brought by Commonwealth. If not, check other box and fill in name of plaintiff in connected case. 19. Fill in name of defendant in connected case, or if style of case is “In re,” fill in case name. 20. Companion case number. See data elements 5-9. 21. Hearing date and time. Additional space is allotted to allow for inclusion of subsequent hearings. DISTRICT COURT MANUAL FORMS VOLUME DECEMBER 2007 American LegalNet, Inc. www.FormsWorkFlow.com Form DC-481 SHOW CAUSE SUMMONS (CIVIL) Page: 4 I impose the following Disposition: 1 [ ] Dismissed on motion of Petitioner. The Respondent was this day: 2 [ ] tried in absence [ ] present RETURNS: Each respondent was served according to law, as indicated below, unless not found. 11 [ ] Placed in custody until the respondent complies with the requirements of the court’s order for a maximum of The Respondent was: [ ] represented by counsel ............................................................... ....................... .......................... 12 [ ] Civil fine of $ 3 payable to ....................................................................... NAME OF COUNSEL ........................................... ....................... .......................... ................................................ 13 [ ] Judgment against garnishee in favor of judgment [ ] not represented by counsel creditor of $ The Respondent: 14 [ ] Other: And was TRIED and FOUND by me: 15 [ ] Appeal Bond $ [ ] not guilty of civil contempt [ ] guilty of civil contempt 5 [ ] See attached Order 16 [ ] Appearance Bond $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [ ] unsecured [ ] secured In addition: 17 [ ] Accrual Bond $ ..................................... [ ] Delivered to family member (not temporary sojourner ......................................... 27 or guest) age 16 or older at usual place of abode of party named above after giving information of its purport. List name, age of recipient, and relation of recipient to party named above. 28 ........................................ ....................... .......................... [ ] Work Release [ ] authorized if eligible [ ] required [ ] not authorized 18 19 [ ] Other: [ ] with interest included 7 [ ] without interest included Telephone No. . . . . . . . . . . . . . . . . . . . . . . . delivered in the following manner: ............................................................... ....................... [ ] PERSONAL SERVICE [ ] Being unable to make personal service, a copy was ..................................................... ............................................................... 6 [ ] that there is a support arrearage of $ ....................... .......................... ................ .............................................. , ...................................................... [ ] Posted on front door or such other door as appears to ............................................................... 8 [ ] that the garnishee should have withheld $ 9 [ ] Pending disposition on 26 ............................................. [ ] denied contempt 4 [ ] did not contest contempt [ ] admitted contempt as of Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . be the main entrance of usual place of abode, address listed above. (Other authorized recipient not found.) [ ] Respondent may purge his/her jail sentence by 20 paying a lump sum of $ ............................ to 29 [ ] Served on Secretary of the Commonwealth. DATE AND TIME [ ] DCSE [ ] the court ORDERS ............................................................................. . . . . . . . . . . . . . . . . .23. . . . . . . . . . . . . . . . . . ... DATE 21 30 [ ] Not found 31 ............................................ SERVING OFFICER ............................................................... 32 ............. ............................................................... ............................................................................. [ ] I ORDER the charge dismissed 10 [ ] with prejudice [ ] without prejudice [ ] Purge Clause ........................................ DATE for 33 ___________________________ 22 [ ] Respondent has been advised of his or her right to appeal the civil contempt. 24 _____________________________________ JUDGE FORM DC-481 (REVERSE) 5/07 DISTRICT COURT MANUAL American LegalNet, Inc. www.FormsWorkFlow.com FORMS VOLUME DECEMBER 2007 Form DC-481 SHOW CAUSE SUMMONS (CIVIL) Page: 5 Data Elements, reverse 1. Check box if case is dismissed on motion of the requesting party. 2. Check applicable box if respondent was present. 3. Check applicable box to indicate if respondent was represented by counsel. If so, enter the name of the counsel. 4. Check box that corresponds to answer of respondent. 5. Check box that corresponds to finding of the court. 16. Check box if appearance bond is required, insert the amount of bond and check box indicating whether bond is secured or unsecured. 17. Check box if accrual bond is required and insert amount of bond. 18. Check box for work release and indicate by checking box whether work release is authorized, required or not authorized. 19. Check box and enter any other disposition. 6. Check box if court finds there is a support arrearage. Enter the amount of the arrearage and effective date. 7. Check box that corresponds to whether arrearage includes interest. 8. Check box if court finds that garnishee should have withheld a sum. Enter the amount that the garnishee should have withheld. 9. Check box if case is continued. Enter interim orders below. 10. Check if the charge is dismissed with box indicating whether charge is dismissed with or without prejudice. 11. Check if respondent is to be incarcerated until there is compliance with the order and enter the maximum time period of incarceration. 12. Check if civil fine imposed and enter the amount of the fine and to whom it should be paid. 13. Check if the court finds in favor of the judgment creditor against the garnishee and enter the amount to be paid by the garnishee to the judgment creditor. 14. Check box and enter any other disposition. 15. Check box if appeal bond is required and insert amount of the bond. 20. Check box for lump sum payment purge provision, enter lump sum amount required to purge contempt and identify DCSE or another payee. 21. Check box and enter any purge provision not indicated in Data Element 20. 22. Check box if respondent notified of right to appeal finding of civil contempt. 23. Date of entry of order. 24. Signature of judge. 25. Name and address (and telephone number if known) of party to be served (to be inserted by clerk or judge). 26. Serving officer to check this box if personal service obtained. 27. Serving officer to check the appropriate box to designate type of substitute service. 28. If served by leaving a copy with a family member age 16 or older, check appropriate box and insert required information. 29. If served on the Secretary of the Commonwealth, check this box. 30. Serving officer to check this box if unable to serve process. 31. Signature of serving officer. 32. Date of signature. DISTRICT COURT MANUAL FORMS VOLUME DECEMBER 2007 American LegalNet, Inc. www.FormsWorkFlow.com Form DC-481 SHOW CAUSE SUMMONS (CIVIL) 33. Name of sheriff if served by deputy sheriff. DISTRICT COURT MANUAL American LegalNet, Inc. www.FormsWorkFlow.com