SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT

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SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT PRINT PETITIONER S/PLAINTIFF S NAME Case No v. PETITIONER/PLAINTIFF, PRINT RESPONDENT S/DEFENDANT S NAME RESPONDENT/DEFENDANT. IV-D Judge MOTION FOR CONTEMPT OF CHILD SUPPORT ORDER Does the Other Party Consent to this Motion? yes no I,, am the PLAINTIFF/PETITIONER in this case. PRINT YOUR NAME DEFENDANT/RESPONDENT 1. This Court has the authority to decide my request for a finding of contempt. 2. A support order was entered in this case on PRINT DATE OF ORDER 3. That support order requires [CHECK ALL THAT APPLY] that the other party pay current child support in the amount of $ Monthly Semi-monthly (twice each month) Bi-weekly (every two weeks) Weekly that the other party pay past due child support in the amount of $ Monthly Semi-monthly (twice each month) Bi-weekly (every two weeks) Weekly DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 1 of 8

that the other party provide medical support in this way other 4. The support order was entered for the following child(ren) that I have with the other party (through birth or adoption) Child s Name Current Address Date of Birth Gender 5. Since the support order was entered, the other party has been able to comply with the order, but has failed to comply with it as follows [CHECK ALL THAT APPLY] Non-payment of current child support. Last payment received PRINT DATE, IF KNOWN Non-payment of past due child support. Last payment received PRINT DATE, IF KNOWN DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 2 of 8

Non-payment of medical support and/or non-enrollment in medical insurance. Other 6. I state the following about Temporary Assistance to Needy Families (TANF) [CHECK ONE] I am currently receiving Temporary Assistance to Needy Families (TANF). I am not currently receiving Temporary Assistance to Needy Families (TANF). 7. I state the following about Medicaid and DC Healthy Families [CHECK ONE] I am currently receiving Medicaid and/or DC Healthy Families. I am not currently receiving Medicaid and/or DC Healthy Families. Request for Relief I RESPECTFULLY REQUEST that the Court [CHECK ALL THAT APPLY] Hold the other party in contempt of court for failure to provide support. Order the other party to spend time in jail until s/he pays the amount of money ( purge amount ) set by the Court after a hearing on this Motion. Other I ALSO REQUEST that the Court award any other relief it considers fair and proper. I DO request an oral hearing in front of the judge on this motion. DO NOT DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 3 of 8

I solemnly swear or affirm under criminal penalties for the making of a false statement that I have read the foregoing Motion for Contempt and that the factual statements made in it are true to the best of my personal knowledge, information and belief. Respectfully Submitted, SIGN YOUR NAME DATE (mm/dd/yyyy) STREET ADDRESS CITY, STATE AND ZIP CODE TELEPHONE NUMBER EMAIL ADDRESS SUBSTITUTE ADDRESS CHECK BOX IF YOU HAVE WRITTEN SOMEONE ELSE S ADDRESS BECAUSE YOU FEAR HARASSMENT OR HARM. DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 4 of 8

POINTS AND AUTHORITIES IN SUPPORT OF MOTION FOR CONTEMPT OF CHILD SUPPORT ORDER In support of this Motion, I refer to 1. Super. Ct. Dom. Rel. R. 7(b) (2003). 2. D.C. Code 11-944 (2001). 3. Bolden v. Bolden, 376 A.2d 430, 432 (D.C. 1977); Smith v. Smith, 427 A.2d 928, 931 (D.C. 1981). 4. The record in this case. 5. The attached supporting document(s), if any. [LIST ANY DOCUMENTS THAT YOU ARE ATTACHING]. DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 5 of 8

CERTIFICATE OF SERVICE for Motions for Contempt of Court HOW YOU SERVE THIS MOTION FOR CONTEMPT ON THE OTHER PARTY DEPENDS ON WHETHER YOU REQUESTED AND RECEIVED A NOTICE OF MOTION OR NOTICE OF HEARING AND ORDER DIRECTING APPEARANCE (NHODA) WHEN YOU FILED YOUR MOTION FOR CONTEMPT. Notice of Motion Service How to Serve if the Final Order in this Case Was Issued 60 or More Days Ago IF YOU REQUESTED AND RECEIVED A NOTICE OF MOTION WHEN YOU FILED THIS MOTION FOR CONTEMPT, YOU MUST SERVE THE NOTICE OF MOTION ON THE OTHER PARTY WITH A COPY OF THIS MOTION. YOU MUST SERVE THE OTHER PARTY BEFORE THE HEARING ON YOUR MOTION. AFTER YOU SERVE THE OTHER PARTY, YOU MUST COMPLETE THE CERTIFICATE OF SERVICE PORTION FOUND AT THE BOTTOM OF THE NOTICE OF MOTION AND FILE IT WITH THE FAMILY COURT CENTRAL INTAKE CENTER. NHODA Service How to Serve if You Want the Court to Be Able to Issue a Bench Warrant IF YOU REQUESTED AND RECEIVED A NHODA WHEN YOU FILED THIS MOTION FOR CONTEMPT, YOU MUST PERSONALLY SERVE THE NHODA ON THE OTHER PARTY WITH A COPY OF THIS MOTION. YOU MUST SERVE THE OTHER PARTY BEFORE THE HEARING ON YOUR MOTION. AFTER YOU SERVE THE OTHER PARTY, YOU MUST COMPLETE THE CERTIFICATE OF SERVICE PORTION FOUND AT THE BOTTOM OF THE NHODA AND FILE IT WITH THE DOMESTIC RELATIONS CLERK S OFFICE. DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 6 of 8

Rule 5 Service How to Serve if Your Case is Still Open and You Do Not Care if the Court is Able to Issue a Bench Warrant I certify that I served a copy of my Motion for Contempt to the other party or the other party s attorney on. PRINT DATE OF SERVICE The papers were delivered [CHECK ONE] by handing it to the other party by first class mail to by fax to PRINT NAME OF PERSON SERVED WITH PAPERS STREET ADDRESS CITY, STATE AND ZIP CODE PRINT NAME OF PERSON SERVED WITH PAPERS FAX NUMBER by leaving a copy at the other party s workplace with a clerk or person in charge, or because there was no one in charge, by leaving it in a conspicuous place PRINT NAME OF PERSON SERVED WITH PAPERS STREET ADDRESS CITY, STATE AND ZIP CODE by leaving a copy at the other party s home with a person of suitable age and discretion who lives there PRINT NAME OF PERSON SERVED WITH PAPERS STREET ADDRESS CITY, STATE AND ZIP CODE SIGN YOUR NAME DATE DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 7 of 8

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT, Plaintiff, Case No v. Judge, Defendant. ORDER Upon consideration of the Motion to filed by the Plaintiff/Defendant and any opposition thereto, it is, this day of, 20, HEREBY ORDERED, that the Motion is granted; and it is further ORDERED, that. cc JUDGE Plaintiff s name Plaintiff s address Defendant s name Defendant s address DC Bar Pro Bono Center (revised 10/2016) Motion for Contempt of Child Support Order Page 8 of 8