FAMILY COURT SERVICES - ROOM WEST ADAMS STREET, JACKSONVILLE, FL (904) CHECKLIST FOR: MOTION FOR CIVIL CONTEMPT/ENFORCEMENT

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FAMILY COURT SERVICES - ROOM 2150 501 WEST ADAMS STREET, JACKSONVILLE, FL 32202 (904) 255-1060 CHECKLIST FOR: MOTION FOR CIVIL CONTEMPT/ENFORCEMENT Use this form to ask the court to enforce a prior court order for the other party who is failing to comply with the court order in your case. You may obtain the following forms at: www.flcourts.org - (select) Self Help, Family Law Forms ALL FORMS MUST BE COMPLETED TO START YOUR CASE Form 12.960 (Attached) o Motion for Civil Contempt/Enforcement Form 12.900(h) (Must be Filed) o Notice of Related Cases PRINTOUT of your Pay History from the Domestic Relations Depository (DRD) (1 st Floor). o Only if your Motion is regarding child support matters INSTRUCTIONS: 1. Fully complete the above forms. 2. Make sure the appropriate forms are notarized. 3. Make three (3) copies of each form. 4. File your original documents with the Family Law Clerk of Courts Room 2474-2 nd floor. NEXT the (3) copies you made o (1) COPY - YOU KEEP FOR YOURSELF o (1) COPY OTHER PARTY o (1) COPY (ONLY IF DOR/CSE ARE INVOLVED)* *Instructions on next page CERTIFIED MAIL WITH A RETURN RECEIPT to: DEPARTMENT OF REVENUE CHILD SUPPORT ENFORCEMENT UNIT ATTN: Service Center Manager Bldg. A Room 150 921 N. Davis Street Jacksonville, FL 32209 FCS (Duval) Checklist: Motion for Civil Contempt/Enforcement (10/31/17) Page 1 of 2

HOW TO NOTIFY BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED Make sure you obtain the following with your form and follow instructions: (1) Envelope (1) Green Card for certified mail (1) White Receipt for return receipt requested Local Form *Notice of Service to Department of Revenue/Child Support Enforcement (DOR/CSE) INSTRUCTIONS: 1. Go to the nearest U.S. Post Office with your envelope with attached green card and receipt. 2. After the copy of your motion has been delivered to DOR/CSE, the Post Office will send you back the Green Card to inform you that it was received. 3. Attach this green card along with the local form and file it with the Clerk of the Courts, Family Law, Room 2474 FCS (Duval) Checklist: Motion for Civil Contempt/Enforcement (10/31/17) Page 2 of 2

IN THE CIRCUIT COURT OF THE FOURTH JUDICIAL CIRCUIT IN AND FOR DUVAL COUNTY FLORIDA CASE NO.: 16- -DR- -FM DIVISION: FM- And Petitioner Respondent,, NOTICE OF SERVICE TO DEPARTMENT OF REVENUE/CHILD SUPPORT ENFORCEMENT (DOR/CSE) BY CERTIFIED MAIL RETURN RECEIPT REQUESTED I HERE BY CERTIFY that the Dept. of Revenue/Child Support Enforcement Unit was served with a copy of: Motion (full name of pleading) Other Documents/Forms By Certified Mail, Return Receipt Requested, Receipt No, at Department of Revenue/Child Support Enforcement, ATTN: Service Center Manager Bldg. A Room 150, 921 N. Davis Street, Jacksonville, FL 32209, on (month and day), 20 as shown by the signed certified mail card (attached to this notice). Address: Signature Telephone: ATTACH CERTIFIED MAIL CARD HERE FCS (Duval) Local Form: Notice of Service to DOR/CSE (08/28/17)

IN THE CIRCUIT COURT OF THE FOURTH JUDICIAL CIRCUIT, IN AND FOR DUVAL COUNTY, FLORIDA, Petitioner, Case No: Division: and, Respondent. MOTION FOR CIVIL CONTEMPT/ENFORCEMENT Petitioner Respondent requests that the Court enter an order of civil contempt/enforcement against Petitioner Respondent in this case because: 1. A final judgment or order {title of final judgment or order} in this case was entered on {date}, by {court, city, and state} Please indicate here if the judgment or order is not from this Court and attach a copy. 2. This order of the Court required the other party in this case to do or not do the following: {Explain what the other party was ordered to do or not do.} Please indicate here if additional pages are attached. 3. The other party in this case has willfully failed to comply with this order of the Court: {Explain what the other party has or has not done.} Please indicate here if additional pages are attached. Florida Supreme Court Approved Family Law Form 12.960, Motion for Civil Contempt/Enforcement (11/15)

4. I respectfully request that the Court issue an order holding the above-named person in civil contempt, if appropriate, and/or providing the following relief: a. enforcing or compelling compliance with the prior order or judgment; b. awarding a monetary judgment; c. if a monetary judgment was included in the prior order, issuing a writ of execution or garnishment or other appropriate process; d. awarding prejudgment interest; e. requiring the other party to pay costs and fees in connection with this motion; f. if the other party is found to be in civil contempt, ordering a compensatory fine; g. if the other party is found to be in civil contempt, ordering a coercive fine; h. if the other party is found to be in civil contempt, ordering incarceration of the other party with a purge; i. issuing a writ of possession for real property, writ for possession of personal property, or other appropriate writ; j. issuing a writ of bodily attachment if the other party fails to appear at the hearing set on this motion; k. requiring the other party to make payments through the central governmental depository; l. requiring the support payments to be automatically deducted from the other party s income or funds; m. requiring the other party to seek employment; n. awarding make-up time-sharing with minor child(ren) as follows {explain}: ; and o. awarding other relief {explain}: Florida Supreme Court Approved Family Law Form 12.960, Motion for Civil Contempt/Enforcement (11/15)

I certify that a copy of this document was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) handdelivered to the person(s) listed below on {date}. Other party or his/her attorney: Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: Designated E-mail Address(es): I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this motion and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated: STATE OF FLORIDA COUNTY OF Signature of Party or his/her attorney Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: Designated E-mail Address(es): Sworn to or affirmed and signed before me on by. NOTARY PUBLIC or DEPUTY CLERK [Print, type, or stamp commissioned name of notary or deputy clerk.] Personally known Produced identification Type of identification produced IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fill in all blanks] This form was prepared for the: {choose only one} ( ) Petitioner ( ) Respondent This form was completed with the assistance of: {name of individual}, {name of business}, {address}, {city},{state}, {zip code} {telephone number}. Florida Supreme Court Approved Family Law Form 12.960, Motion for Civil Contempt/Enforcement (11/15)