Fill and Sign the Child Support Unc School of Government Form

Court File No. STATE OF NORTH CAROLINA Nature of Interest In This Action Deputy CSC Assistant CSC Clerk Of Superior Court Signature Of Person Authorized To Administer Oaths Signature Of Person Making Motion Judge Assistant CSC Clerk Of Superior Court Time Of Hearing Signature Date Issued Place Of Hearing AM PM Date Of Hearing The Court finds probable cause to believe that you are in civil or criminal contempt for failing to comply with the Court's order as specified above. You are Ordered to appear at the date, time and place set out below to show cause, if any, why the Court should not enter an order holding you in civil or criminal contempt. Your failure to appear as ordered may result in the issuance of an Order For Arrest or your bein g jailed for civil contempt. TO THE ORDER TO APPEAR AND SHOW CAUSE PLAINTIFF DEFENDANT NAMED ABOVE: IV-D Case No. Other: e. I am informed and believe that the obligor has the means to comply with the Court's order. 2. b. c. failing to provide obligee with a medical insuran ce card or information required to file a claim for the child(ren). failing to provide medical insurance for the child( ren). d. failing to pay child support. The obligor owes $ in past-due child support as of (date). The obligor has willfully failed to comply with an Order dated by 1. I, the undersigned, request the Court to issue an o rder requiring the obligor to appear and show cause , if any, why he/she should not be held in civil or criminal contempt fo r his/her failure to comply with the Court's order, and in support of the motion, present the following information: a. failing to pay medical expenses in the amount of $ . SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME Date SEAL Date My Commission Expires Notary Date Plaintiff Other Defendant (Over) County MOTION AND ORDER TO SHOW CAUSE FOR FAILURE TO COMPLY WITH ORDER IN CHILD SUPPORT ACTION In The General Court Of Justice District Court Division AOC-CV-601, Rev. 3/09 © 2009 Administrative Office of the Courts G.S. 50-13.4; 5A-21 Name And Address Of Obligor Name Of Plaintiff VERSUS Name Of Defendant Name And Address Of Obligee County Where Notarized ` PM AM By leaving a copy of this Motion and Order at the dwelling house or usual place of abode of the obligo r named above with a person of suitable age and discretion residi ng therein. leaving a copy at the office of the attorney named below, with a partner or employee depositing a copy in the United States mail in an e nvelope bearing proper postage and addressed as fol lows: delivering a copy personally to: Signature Of Person Who Served Motion And Order Name Of Person With Whom Copy Left Address Where Copy Delivered Or Left Date Accepted Name Of Sheriff (Type Or Print) County Of Sheriff Signature Of Deputy Sheriff Making Return Date Received Date Of Return RETURN OF SERVICE I certify that this Motion and Order was received and served as follows: Date Served Name Of Obligor Time Served Name Of Person With Whom Copy Left Name Of Person With Whom Copy Left Name And Address Name Of Attorney Party Represented Person With Whom Copies Left Name And Address Name Of Attorney Party Represented Person With Whom Copies Left AOC-CV-601, Side Two, Rev. 3/09 © 2009 Administrative Office of the Courts