COUNTY STATE OF WISCONSIN, CIRCUIT COURT, DANE For Official Use Creditor(s) (Name and Address): Motion and Order for Hearing on Contempt -vs- Debtor(s) (Name and Address): Case No. UNDER OATH, I STATE: 1. I was awarded a judgment for money damages under Ch. 799, Wis. Stats., against (Name) , in the amount of $ . as judgment debtor on (Date) 2. A copy of the order for Financial Disclosure Statement was mailed or delivered to the judgment debtor. 3. More than 15 days have elapsed from the date of entry of judgment and the judgment debtor has failed to comply with the order of the court and has given no reason for the failure to comply. the judgment debtor has failed to accurately or completely fill out the Financial Disclosure Statement. I ask that the court schedule a hearing to determine why the judgment debtor has failed to comply with the Order for Financial Disclosure Statement. Subscribed and sworn to before me on Judgment Creditor Notary Public, State of Wisconsin Date My commission expires: THE COURT ORDERS: 1. The judgment debtor shall appear in person as stated below to answer why the judgment debtor has failed to comply with the Order for Financial Disclosure Statement. Date Time Location (include Room No.) Dane County Courthouse Courtroom ___________ 215 South Hamilton Street Madison, WI 53703 - 3285 Circuit Court Judge 2. This motion and order shall be served on the judgment debtor by personal service, unless otherwise authorized by law in §801.14(1)(2), Wisconsin Statutes. 3. The judgment debtor may avoid appearing at this hearing only by, prior to the hearing date, either (a) paying the judgment in full, or (b) delivering an accurate and complete Financial Disclosure Statement to the judgment creditor. 4. If the judgment creditor does not appear at this hearing, this motion may be dismissed. A finding of contempt for nonappearance or failure to comply with the court’s order may result in any or all of the following penalties: • Imprisonment for up to 6 months. • Forfeiture of not more than $2000 per day. • Any other order necessary to ensure your compliance. If you require reasonable accommodations due to a disability to participate in the court process, please call Court ADA Coordinator (608) 266-4311 at least 10 working days prior to TDD (608) 266-4625 the scheduled court date. Please note that the court does not provide transportation. BY THE COURT: Circuit Court Judge/Circuit Court Commissioner Name Printed or Typed Date SC-507, 02/10 Motion and Order for Hearing on Contempt §§799.26 and 801.14(2), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. American LegalNet, Inc. www.FormsWorkFlow.com