Superior Court of Washington County of In re: No. Petitioner, and Motion/Declaration for an Order to Show Cause re Contempt (MTSC) Respondent. I. Motion (Name of requesting party) ________________________________________ moves the court for an order directing (name of other party) ___________________________________ to appear personally before the court and show cause why an order should not be entered: 1.1 Finding Contempt [] [] Does not apply. Finding contempt for failure to comply with: [] [] [] [] [] the order of child support the order of maintenance the parenting plan/custody order the restraining order other: Signed by the court on (date) __________________________________ in (county and state) ____________________________________________. 1.2 Establishing a Judgment [] [] Does not apply. Establishing a judgment in the amount of $ _____________ plus $ _____________ interest for delinquent child support and $__________________ costs for the period from (date) _______________________ through (date) ___________________________. Mot/Dec Ord Show Cause re Contempt (MTSC) - Page 1 of 3 WPF DRPSCU 05.0100 Mandatory (10/2009) - RCW 26.09.160 American LegalNet, Inc. www.FormsWorkFlow.com [] [] [] 1.3 Granting Sanctions [] [] [] 1.4 Establishing a judgment in the amount of $ _____________ plus $ _____________ interest for delinquent medical support and $__________________ costs for the period from (date) _______________________ through (date) ___________________________. Establishing a judgment in the amount of $ _____________ plus $ _____________ interest for delinquent child care, educational expenses, transportation expenses, or other special expenses and $__________________ costs for the period from (date) ________________ through (date) ___________________. Establishing a judgment in the amount of $ ____________ plus $ ____________ interest for delinquent maintenance and $ _______________ costs for the period from (date) ________________________ through (date) __________________________. Does not apply. Granting sanctions for contempt, including a forfeiture for each day the contempt of court continues, and establishing conditions by which the contempt may be purged and granting any other relief, including reasonable attorney fees and costs and make up residential time, as may be appropriate under Chapter 7.21 RCW, Chapter 26.09 RCW, Chapter 26.10 RCW, Chapter 26.26 RCW, and RCW 26.18.040. Imprisonment is sought as a sanction. Other This motion is based upon the declaration which follows. Dated: Signature of Requesting Party or Lawyer/WSBA No. Print or Type Name II. Declaration (Name) ________________________________ should be held in contempt for the following reasons: [] Failure to comply with the provision of the child support order which directed payment of: [] [] current child support in the amount of $ _______________ per month. medical support, including health insurance coverage and cash medical support as described below: [] child care, educational expenses, transportation expenses, or other special expenses as described below: Mot/Dec Ord Show Cause re Contempt (MTSC) - Page 2 of 3 WPF DRPSCU 05.0100 Mandatory (10/2009) - RCW 26.09.160 American LegalNet, Inc. www.FormsWorkFlow.com [] Other: [] Failure to comply with the maintenance order which directed payment of maintenance in the amount of $ _______________ per month as described below: [] Failure to comply with the parenting plan as follows: [] Failure to comply with the restraining order as which required: This order was violated in the following manner: [] Other: I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Signed at (city) _________________________ (state) ____________ on (date) _____________________. Signature of Requesting Party Print or Type Name Mot/Dec Ord Show Cause re Contempt (MTSC) - Page 3 of 3 WPF DRPSCU 05.0100 Mandatory (10/2009) - RCW 26.09.160 American LegalNet, Inc. www.FormsWorkFlow.com