Clicking on the question marks ( ) will give you information about that section of the form.
Print or type name of person signing
The court orders the plaintiff the defendant to attend a hearing at the time and place shown below to show why you
are not in contempt. The Court also orders the plaintiff the defendant to give notice to the opposing party of the
Motion and of the time and place where the Court will hear it, by having a true and attested copy of the Motion and this Order
mailed or delivered to the opposing party by any proper officer at least 12 days before the date of the hearing. Proof of
mailing or delivery must be made to this Court at least 6 days before the hearing.
Other:
Family Support Magistrate Division
Certification (Complete if motion is filed before judgment (pendente lite))
Before Judgment (pendente lite)
(Check one)
plaintiff I ask the Court to find the
The
past due amount you claim is due as of the date of this motion or another specific date.)
plaintiff or
MOTION FOR CONTEMPT/
CONTEMPT CITATION
JD-FM-173 Rev. 2-15
C.G.S. § 46b-87; 46b-220 P.B. § 25-27
STATE OF CONNECTICUT
SUPERIOR COURT
www.jud.ct.gov
Plaintiff
defendant has disobeyed the court order in the following ways: (Please be specific. Include the amount of any
After Judgment
I, the
Pay child support in the amount of
per
Pay alimony in the amount of
per
Order To Attend Hearing and Notice (To be completed by the Court)
By the Court (Judge/Assistant Clerk)
Date signed
Superior Court, Judicial District of
Court address
Date
Hearing To
Be Held At
Time
Telephone (Area code first)
If you do not come to the court hearing, a civil arrest order (capias) may be issued against you.
(Continued on page 2)
*Check appropriate court: Superior Court
defendant to (fill out only the box (or boxes) below for the order (or orders) you are claiming was (or were) disobeyed):
plaintiff
Defendant, respectfully represent that this Court issued an order on
defendant in contempt. I certify that the above information is true to the best of my knowledge.
Room number (If known)
Signature*
directing the
Court Use Only
Judicial District of
At (Town )
Docket number
Plaintiff's name (Last, first, middle initial)
Defendant's name (Last, first, middle initial)
Plaintiff's address (Number,street, city, state, zip code) Defendant's address (Number,street, city, state, zip code)
(month, day, year)
Total balance owed
As of (Date)
Have visitation or parenting time as follows: (Attach a copy of the visitation schedule if available)
Pay medical bills or provide health insurance as follows:
Date
Telephone (Area code first)
Name of attorney or self-represented litigant Address of attorney or self-represented litigant
MFCONTP
COURT USE ONLY
Use this docket legend when the
Certification has been filled out, but
there is no Order to Attend Hearing
and Notice.
*MFCONTP*
*CONTCPL*
Use this docket legend when the
Order to Attend Hearing and Notice
has been filled out and the "After
Judgment" box is checked.
CONTCIT
*CONTCIT*
CONTCPL
Use this docket legend when the
Order to Attend Hearing and Notice
has been filled out and the "Before
Judgment" box is checked.
ADA NOTICE
The Judicial Branch of the State of Connecticut complies with the Americans with
Disabilities Act (ADA). If you need a reasonable accommodation in accordance with
the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA.
Pay arrearages in the amount of
per
to all attorneys and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and
self-represented parties of record who were or will immediately be electronically served.
Signed (Signature of filer)
u
I certify that a copy of this document was or will immediately be mailed or delivered electronically or non-electronically on (date)
*If necessary, attach additional sheet or sheets with name and address which the copy was mailed or delivered to.
Name and address of each party and attorney that copy was mailed or delivered to*
Date signed
Telephone number
Mailing address (Number, street, town, state and zip code)
