Name of Violator
☐ Mark this box if this form contains Restricted Information.
☐ CIRCUIT COURT ☐ DISTRICT COURT OF MARYLAND FOR |
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NOTE: Respondent will be served a copy of this completed document. Petitioner does not need to give an address if doing so risks further harm.
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Name of Petitioner on Original Court Order |
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Name of Respondent on Original Court Order |
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Street Address, Apt. No. |
Home |
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Street Address, Apt. No. |
Home |
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Work |
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PETITION FOR CONTEMPT (Violation of Protective Order)
MDEC counties only: If this submission contains Restricted Information (confidential by statute, rule or court order) you must file a Notice Regarding Restricted Information Pursuant to Rule 20-201.1 (form MDJ-008) with this submission, and check the Restricted Information box on this form.
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I, |
Name |
, state that: |
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1. On |
☐ the court ordered the following: |
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OR |
☐ a copy of a protective order issued by the following out-of-state (or Native American) court: |
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was filed with this court. |
2. Regarding that court order, I am the ☐ petitioner ☐ respondent ☐ other (explain) |
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Name of Violator |
has violated the court order as follows: (state in detail when, where, and how the |
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violation occurred) |
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I request the court grant an order finding that
is in contempt of court and grant any other relief necessary in this case.
☐I request that the court send the respondent to jail until the court's order is obeyed.
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Signature |
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Street Address (unless confidential) |
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CERTIFICATE OF SERVICE |
City, State, Zip |
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I certify that I served a copy of this petition upon the following party or parties by ☐ mailing first-class mail, postage prepaid
☐ hand delivery, on |
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to: |
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Name |
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Signature of Party Serving |
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Home Address: |
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DESCRIPTION OF ALLEGED VIOLATOR |
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Home Telephone: |
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Work Address: |
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Work Telephone: |
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Employer: |
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Work Hours: |
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Other Places/Times They Can Be Found: |
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DESCRIPTION: Driver’s License # |
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State |
Race |
Sex |
Ht |
Wt |
Hair |
Eyes |
DOB |
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FBI # |
SID # |
SSN XXX-XX- |
Complexion |
Tattoos, Marks, Scars |
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Other |
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CC-DC-DV-007 (Rev. 04/2022) |
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Reset |
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PECDV |