Establishing paternity custody parenting time and child support form
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INSTRUCTIONS FOR YOUR ENFORCEMENT HEARING
(Child support, health care expenses, childcare expenses)
Try to arrive at your hearing at least 15 minutes before your hearing is
scheduled. Once you arrive at the courtroom for your hearing, you should ask the clerk
of the district court how to let the judge know that you are there for your contempt
hearing.
When the court calls your case, you will be asked if you are ready to proceed.
You must tell the court that you are ready and would like to testify. You will be asked to
take the stand and the court will give you an oath to tell the truth. You are then ready to
go forward with your case.
You must testify to the following:
1. My name is _______________________. I live at ______________________, in
(your full name)
(your current street address)
___________________________, and I am the _______________ in this case.
(city and state where currently living)
(plaintiff or defendant)
2. I request that the court take judicial notice of the file, including all previous support orders
and the Order to Show Cause and the sheriff’s return showing
__________________________________ has been served with a copy of the
(name of person you are filing against)
Order to Show Cause.
3. _____________________________ and I are the parents of ________ child(ren).
(name of person ordered to pay support)
(number of children)
______________ of these child(ren) are/is not yet 19 years old.
(number of children under 19)
4. The child support order currently in effect was entered on
_________________________, and has not been modified. In that order,
(date of most recent order for child support)
______________________________ was ordered to pay the following:
(name of person ordered to pay support)
(Check/read the statements that apply:)
(a) Child support of $__________________ per month for ___________ children
(amount of support)
(number of children)
$__________________ per month for ___________ children
(amount of support)
(number of children)
$__________________ per month for ___________ children
(amount of support)
Page 1 of 6
Instructions for your Enforcement Hearing
DC 6:5.23 Rev. 06/19
(number of children)
$__________________ per month for one child.
(amount of support)
(b) __________________________ percent of all nonreimbursed reasonable
(percent of health care costs currently ordered to be paid)
and necessary child(ren)'s health care costs in excess of $480 per child per
year.
(c)______________________________ percent of any childcare costs which
(percent of childcare expenses currently ordered to be paid)
are due to my employment or to allow me to obtain training or education
necessary to obtain a job or enhance earning potential.
5. (Choose one or more of the following, depending on whether you are asking the
court to enforce the order for child support, health care costs, or childcare
costs:)
a. _____________________________________ has not paid the child
(name of person ordered to pay child support)
support the court ordered.
b. _______________________________________ has not paid the
(name of person ordered to pay health care expenses)
health care expenses the court ordered.
c. ______________________________________ has not paid the
(name of person ordered to pay childcare expenses)
childcare expenses the court ordered.
6. (If you are seeking enforcement of child support, continue with these statements:)
a. May I approach the court reporter and have the certified copy of the
payment history and the child support arrearages marked as an
exhibit? (If permission is granted, have the certified copy marked as
an exhibit, and then ask permission to show it to the other side.)
b. I offer Exhibit _______ into evidence. (If the judge receives it,
(number assigned by court reporter)
hand it to the judge.)
Page 2 of 6
Instructions for your Enforcement Hearing
DC 6:5.23 Rev. 06/19
c. ________________________________________ now owes
(name of person ordered to pay child support)
$______________________________ in back child support and
(amount owed — amount is shown on the payment history)
has refused to pay it. ____________________________________
(name of person ordered to pay child support)
is able to earn sufficient income to pay the support.
7. (If you are seeking enforcement of health care costs, continue with these statements:)
a. During the time of _________________________________________,
(state period of time covered by bills you are trying to collect)
I have incurred $____________________ in health care expenses for
(total amount of expenses incurred )
____________________________________. I have been reimbursed
(name of child incurring expense)
$__________________________ by the insurance company for these
(amount reimbursed by an insurance company)
expenses. I gave ____________________________________ notice
(name of person ordered to pay health care expenses)
of these expenses, but I have not yet received any reimbursement for
them, nor has the medical provider been paid directly by
_______________________________________.
(name of person ordered to pay health care expenses)
(*Repeat this statement for each child who has expenses for which
you are seeking reimbursement.)
b. (If you have copies of the medical bills, you should have them marked
as an exhibit.) May I approach the court reporter and have the
medical bills marked as an exhibit? (If permission is granted have the
bills marked, and then ask permission to show the exhibit to the other
side.)
c. I received these medical bills, which have been marked as
Exhibit(s) ______, from the doctors, hospitals, clinics (others) shown
(number assigned by court reporter)
on the bills..
Page 3 of 6
Instructions for your Enforcement Hearing
DC 6:5.23 Rev. 06/19
d. I offer Exhibit(s)_________ into evidence. (If the judge receives it,
(number assigned by court reporter)
hand it to the judge.)
e. The balance owing on ______________________________'s share of
(name of person ordered to pay health-related expenses)
the medical expenses is $____________________. I have asked for
(amount owed on health care expenses)
payment, and _______________________________________ has
(name of person ordered to pay health care expenses)
refused to pay. _________________________________________
(name of person ordered to pay health care expenses)
is able to earn sufficient income to pay the health care expenses.
8. (If you are seeking enforcement of childcare expenses, continue with these statements:)
a.
During the time ___________________________________________
(state period of time covered by expenses you are trying to collect)
I have incurred $_____________________ in child-care expenses for
(amount of childcare expenses you are seeking to collect)
my children, _____________________________________________.
(names of child(ren))
I gave ___________________________ notice of these expenses, but
(name of person ordered to pay childcare expenses)
have not yet received any reimbursement for them nor has the childcare provider been paid directly by ______________________.
(name of person ordered to pay childcare expenses)
b. This child care was necessary because (choose statements that apply):
(1) I was working;
(2) I was in training for a job;
(3) I was in school so that I could get a job or have a better chance
to increase my earning ability.
c.
Page 4 of 6
I received childcare bills from the provider.
Instructions for your Enforcement Hearing
DC 6:5.23 Rev. 06/19
d.
(If you have copies of the childcare bills, you should have them
marked as an exhibit.) May I approach the court reporter and have
the childcare bills marked as an exhibit? (If permission is granted
have the bills marked and then ask permission to show the exhibit to
the other side.)
e.
I offer Exhibit(s)___________ into evidence. (If the judge receives it,
(number assigned by court reporter)
hand it to the judge.)
f.
The balance owing on ______________________________'s share
(name of person ordered to pay childcare expenses)
of the childcare expenses is $_______________________. I have
(amount for which you are asking reimbursement)
asked for payment and ___________________________________
(name of person ordered to pay childcare expenses)
has refused to pay. _____________________________________
(name of person ordered to pay childcare expenses)
is able to earn sufficient income to pay the childcare expenses.
9. (Use this statement if the person required to pay support is employed:)
____________________________________ is employed.
(name of person ordered to pay support)
(Give further information about the employment, such as the name of
the employer, wages and length of time on the job, if you know it.)
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________ is able to pay the support, but has
(name of person ordered to pay support)
intentionally not made the payments the court ordered.
Page 5 of 6
Instructions for your Enforcement Hearing
DC 6:5.23 Rev. 06/19
10. (Use this statement if the person required to pay support is not employed:)
_____________________________________ is not currently working.
(name of person ordered to pay support)
I believe _____________________________________ is healthy and
(name of person ordered to pay support)
capable of earning wages.
The last employment I am aware that __________________________________
(name of person ordered to pay support)
had was:
________________________________________________________________.
(name of last known employer)
(Give any information you have about that employment:)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
11. ____________________________________________ has intentionally
(name of person ordered to pay support)
refused to pay (choose the orders you are seeking to enforce:) child support,
health care expenses, and/or childcare expenses.
12. I request that you find ___________________________________________
(name of person ordered to pay support)
in contempt of court for failing to pay (choose the orders you are seeking to
enforce:) child support, health care expenses, and/or childcare expenses.
13. I have nothing further, your Honor.
Page 6 of 6
Instructions for your Enforcement Hearing
DC 6:5.23 Rev. 06/19
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FAQs
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