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o CIRCUIT COURT o DISTRICT COURT OF MARYLAND FOR...............................................
Located at............................................................................................ Case No. .........................................
Court Address

......................................................................................
Name of Petitioner on Original Court Order Street Address, Apt. No.

vs.

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Name of Respondent on Original Court Order Street Address, Apt. No.

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Home: Work: ...................................................................................... Telephone City, State, Zip Code

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Home: Work: ...................................................................................... City, State, Zip Code Telephone

PETITION FOR CONTEMPT
I, ................................................................................................., state that:
Print Name

1. On the..................... day of .............................................., .......................... ¨ this Court ordered the following
Month Year

................................................................................................................................................................................... .....................................................................................................................................................................OR

¨ an authenticated copy of a protective order passed by................................was filed with this Court.
2. That....................................... has violated the Court order as follows: (state in detail when, where and how the violation occurred)............................................................................................................................................... ................................................................................................................................................................................... ................................................................................................................................................................................... ................................................................................................................................................................................... ................................................................................................................................................................................... ................................................................................................................................................................................... WHEREFORE, I request that this Court pass an order finding that................................................................................. Name of Violator is in contempt of Court, and granting any other relief that is necessary in this case. ¨ I request that the Court send the Respondent to jail until the Court's order is obeyed. ...................................................................................... Date I am the Petitioner.................................................................. Respondent .............................................................. Person Eligible for Relief ........................................ Other (explain)......................................................... ...................................................................................... ...................................................................................... ......................................................................................
Signature

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Street Address (unless confidential)

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City, State, Zip Code

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Telephone

DESCRIPTION OF ALLEGED VIOLATOR
Home Address:.................................................................................................................................................................. ...................................................................................................................Home Telephone:........................................... Work Address: .................................................................................................................................................................. ...................................................................................................................Work Telephone: ........................................... Employer:..................................................................................................Work Hours:................................................... Other Places and Times Respondent Can Be Found: ....................................................................................................... ........................................................................................................................................................................................... ........................................................................................................................................................................................... Height .................Weight...................... Sex ................ Race ................... Hair Color .......................... Eye Color ......... Other (tattoos, scars, etc.).................................................................................................................................................. Date of Birth.................................................................... Rev. ( 7/2003) CC-DC/DV 7 (2/2003)

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