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3108EN | May 2019

File a Motion for Contempt: Family Law Cases Instructions and Forms

3108EN | May 2019

Table of Contents | Page 1

Contents

Part 1. Important Info ........................................................................................................... 1

A. How much does a Motion for Contempt cost? .......................................................................... 1

B. Where should I file my motion? ..................................................................................................... 1

C. What if the other party is in the military or a military dependent? ................................ 2

D. What if I have questions that this packet does not answer? ............................................... 2

Part 2. Checklist of Steps ...................................................................................................... 3

Part 3. Forms in this Packet ................................................................................................ 6

A. Forms you will need ........................................................................................................................... 6

B. Forms you may need .......................................................................................................................... 6

Part 4. Other court forms and documents you may need to get........................... 7

Part 5. General instructions for filling out forms ........................................................ 8

Part 6. How to fill out each required form .................................................................. 12

A. Motion for Contempt Hearing – FL All Family 165 .............................................................. 12

B. Order to go to Court for Contempt Hearing - FL All Family 166 .................................... 13

C. Notice of Appearance – FL All Family 118............................................................................. 13

D. Contempt Hearing Order After Contempt Hearing - FL All Family 167 ...................... 14

Part 7. How to fill out forms you may need ................................................................ 17

A. Declaration of: – FL All Family 135............................................................................................ 17

B. Confidential Information Form and Attachment - FL All Family 012 .......................... 19

C. Sealed Personal Health Care Records (Cover Sheet) –FL All Family 012 ................... 20

D. Sealed Confidential Reports (Cover Sheet) – FL All Family 013 .................................... 21

E. Sealed Financial Source Documents– FL All Family 011 .................................................. 22

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Table of Contents | Page 2

Part 8. How to file forms with the court ...................................................................... 23

A. Filing your Motion with the Court and Asking the Judge to Sign Your Order ........... 23

Part 9. How to serve forms ................................................................................................ 25

A. Instructions for Personal Service in Washington ................................................................ 26

B. If you do not serve the other parties on time ........................................................................ 29

Part 10. Getting Ready for Your Hearing .................................................................... 30

A. Working Papers and Confirming Your Hearing .................................................................... 30

Part 11. Words you should know .................................................................................. 34

Part 12. Blank Forms .......................................................................................................... 36

This publication provides general information concerning your rights and responsibilities. It is not intended as a substitute for specific legal advice.

This information is current as of May 2019.

© 2019 Northwest Justice Project — 1-888-201-1014.

(Permission for copying and distribution granted to the Alliance for Equal Justice and to individuals for non-commercial use only.)

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File a Motion for Contempt | Page 1

Part 1. Important Info Use this for help filling out and filing the necessary papers if both of these are

true:

you already have a temporary or permanent parenting plan, child

support order, or other family law order

you want the court in the same Washington county to issue an order

holding the other party in contempt for violating it

Read this with Contempt of Court in Family Law Cases – The Basics.

Before using this packet, talk with a lawyer. See “What If I Have Questions?” below for

free and reduced-cost referrals. Even if you cannot afford to pay one to handle your case

for you, a lawyer may advise you about important legal rights that your motion may affect.

Example 1: The other party may counter-file for contempt against you or file to

change earlier court orders in your case. The court may not give you what you ask

for. It may grant the other party’s requests.

Example 2: your parenting plan requires you to use a dispute resolution procedure

before you return to court. A lawyer can advise you how to do this, and if there are

better choices than filing for contempt.

If the Division of Child Support (DCS) is handling collection of your child support, ask them

about filing a contempt motion for back support. They will do much of the paperwork, file

the case, serve the other party, and help the case move through the court. The prosecutor

will not be your lawyer and will not represent either parent. The prosecutor will represent

the child’s interest in support and the State’s interest in support due to it if the children got

public assistance. Asking for the State’s help may delay the filing of your case. The

prosecutor must agree with any final settlement you make with the other party.

A. How much does a Motion for Contempt cost?

Many counties charge copying fees, and sometimes fees for service (delivering the papers

to the other parent or other parties). You should not have to pay any new filing fee.

B. Where should I file my motion?

In most cases, you should file in the Superior Court of the county that entered your original

court order. This packet covers only this type of case.

http://www.washingtonlawhelp.org/resource/contempt-of-court-in-a-family-law-case-the-ba?ref=guSX8

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If you decide to file in another county, or you are trying to enforce an order from another

state or from an administrative law judge, you must register your original order. You must

also pay a filing fee or ask the court to waive it.

C. What if the other party is in the military or a military dependent?

If the other party is a member on active military duty,1 or the dependent2 of someone who

is, talk to a lawyer before filing your motion. Special rules may limit the court’s ability to

make any orders adversely affecting the service member’s or protected dependent’s rights.

D. What if I have questions that this packet does not answer?

Talk to a lawyer familiar with family law before filing anything with the court. Some

counties have family law facilitators. They can help you fill out forms. There may also be

free legal clinics where you can get advice about your case.

Do you live in King County? Call 211, weekdays 8:00 a.m. - 6:00 p.m. From a pay

or public phone, call 1-800-621-4636. They will identify and refer you to the

appropriate legal aid provider.

Apply online with CLEAR*Online - nwjustice.org/get-legal-help

Call the CLEAR Legal Hotline at 1-888-201-1014.

1 See the federal Service Members Civil Relief Act, 50 U.S.C. App. Sections 501 et seq. For Washington State’s Service Members Civil Relief Act, see RCW 38.42.010 et seq.

https://nwjustice.org/get-legal-help

https://nwjustice.org/get-legal-help

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Part 2. Checklist of Steps

This section lists in order the steps to file this Motion. Use this checklist as you go through

your case. We explain many of the steps in more detail later in this packet.

1. Learn about contempt law in Washington. Go to WashingtonLawHelp.org. Read

Contempt of Court in Family Law Cases — the Basics. Filing for contempt is not always

the right solution, even if someone is violating a court order. It may put you at risk of

defending a contempt motion against you or a motion to modify.

2. Check for and use special local forms, procedures and rules.

Local court requirements will affect how you handle your case. Your county may have

special forms or have local rules you must follow. It may require case schedules, classes,

or settlement conferences. Ask the court clerk or family law facilitator (if there is one) for

the court where your case is filed about local requirements. Tell them you have a

contempt case. Requirements may differ, depending on your case type.

Read your local court rules. They are available at the county law library and often at

courts.wa.gov/court_rules/?fa=court_rules.local&group=superior

Look at the “Words you should know” section of this packet if you do not know words used

here.

Find out:

o If the county has its own packets or forms for your type of family law case,

use theirs instead of ours

o If you use our packet, get any other local forms you will need

o if the court uses case schedules (and if the court requires the person filing

the case to serve the schedule on the other parties)

o if your county allows you and/or witnesses to testify at the hearing, find out

what to do before the hearing to get permission to testify and to subpoena

witnesses

o how much advance notice of the contempt hearing to give the other party

3. Make sure you know who you must serve or is a party to the case. The caption of

http://www.washingtonlawhelp.org/


http://www.courts.wa.gov/court_rules/?fa=court_rules.local&group=superior

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the order you are trying to enforce should show all parties. The party you believe is in

contempt may be the only other party. If the motion affects child support and your

child has ever gotten TANF or Medicaid, or is in foster care or out-of-home placement,

or DCS is trying to collect support, get our Serving Papers on the State packet. If

someone besides a parent has custody of a child in the parenting plan, that person may

be a party. You must also serve any GAL or evaluator in your case.

4. Make sure you know how to find the other parties (home address, or place of

work) so you can arrange to serve them with your papers.

5. Get a certified copy of the court order you are trying to enforce. You can get it at

the Superior Court Clerk’s office in the county of the court that decided your case. Read

the order carefully. Make sure it clearly states the duty the other party has violated.

Make sure you are meeting your own responsibilities under the order. Make sure

there is no later order changing the order you want to enforce. Make sure the order has

not ended. (Many restraining orders end on a certain date or when the court enters

final orders.)

6. Fill out the forms to file for contempt.

7. Make the needed copies of each completed form you are filing with the court.

8. Go to the courthouse to:

File your papers with the Superior Court Clerk

Get the judge’s signature on the Order to Go to Court for Contempt Hearing (Order

to Show Cause)

Get a certified copy of the order you are trying to enforce from the clerk (this will

cost a few dollars)

Have the clerk “conform” copies of all the documents you are filing

9. Organize your copies for service.

10. Arrange to serve the papers on the other parties.

If you do not have the other party personally served, your motion may not be able to

go forward. Do not serve the papers yourself.

If the State is a party to your case or DCS is collecting or trying to collect support in

your case, and your Motion for Contempt concerns support, you must serve DCS

with the papers. Use our Serving Papers on the State packet.

http://www.washingtonlawhelp.org/resource/how-to-serve-papers-on-the-state?ref=bRqkm


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11. File the completed Proof of Personal Service after the papers have been

served.

12. If required, deliver working papers and confirm the hearing.

13. Wait until the other party’s time to file a Response to your motion ends. Read

whatever they file. The other party has several days to file and serve a response to a

motion for contempt. What they file will help you decide what to do to finish your

motion.

14. Read any response or other documents the other party has served on you.

File your own documents in reply, if permitted.

15. Go to your hearing. Fill out the Contempt Hearing Order to describe the judge’s

decision on your motion. Have the judge sign that order. File it with the court. Get a

copy to the other party.

16. Decide whether to ask for Revision, if needed. See Part 10.

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Part 3. Forms in this Packet

A. Forms you will need

Court Form Title Court Form Number

Motion for Contempt Hearing FL All Family 165

Order to Go to Court for Contempt Hearing FL All Family 166

Contempt Hearing Order FL All Family 167

Notice of Appearance FL All Family 118

Proof of Personal Service FL All Family 101

B. Forms you may need

Court Form Title Court Form Number

Declaration of: FL All Family 135

Confidential Information Form and Attachment

FL All Family 001 & FL All Family 002

Sealed Personal Health Care Records FL All Family 012

Sealed Confidential Reports FL All Family 013

Sealed Financial Source Documents FL All Family 011

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Part 4. Other court forms and documents you may need to get

You may need other forms and documents depending on the facts of your case. Read the

following list. Check the other packets you think you will need from CLEAR or

WashingtonLawHelp.org. Get those before filling out and filing your forms in this packet.

Local County Court Forms and Rules - Some counties have other special forms you

need. They are not in this packet. Most will have local rules you need to know to file

your motion. Check with the Court Clerk or Family Law Facilitator.

Some county clerk’s offices have forms and local rules available online at

courts.wa.gov/rules/local.cfm?group=superior.

Contempt of Court in a Family Law Case: The Basics: Has general info about the type

of contempt most commonly used in family law cases, “coercive civil contempt.”

Subpoenaing Witnesses and Documents: If you are going to a hearing or trial with live

testimony, use this to make sure a witness shows up or brings documents. You can

have them served with a subpoena issued by the clerk. Before using this packet, find

out if the court allows live testimony at contempt hearings.

Working Copies: If court rules require you to serve working papers or working copies.

You may want to do this even if your county does not require them.

Serving Papers on the State: If any party is asking for a child support order, and any of

the children has gotten TANF or medical coupons or Medicaid, or is in foster care or

out-of-home placement. You must include the state as a party and serve them with

papers you file.

Notice of Address Change (FL All Family 120): If you move during or after your case.

Fill this out, file it with the court, and get all other parties a copy. Get it at

courts.wa.gov/forms.

We offer many other publications, in family law and other areas. Visit

WashingtonLawHelp.org for a complete listing.

http://www.courts.wa.gov/rules/local.cfm?group=superior


http://www.washingtonlawhelp.org/resource/how-to-subpoena-witnesses-and-documents?ref=o7BSl

http://www.washingtonlawhelp.org/resource/what-are-working-copies?ref=ZdnVX


http://courts.wa.gov/forms


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Part 5. General instructions for filling out forms

Read this section before you start filling out any forms.

These apply to all forms. They cover all family law cases. You may not use

some of this info.

The caption includes your case name and number, the court name, the title of the court

paper, and sometimes, the type of case. It appears at the top of the first page of every form.

You can copy the caption on the order you are trying to enforce. See the sample below:

Superior Court of Washington, County of

In re the marriage of:

Petitioner (person who started this case):

Jane Brown

And Respondent (other spouse):

John Brown

No. Notice of Hearing (NTHG)

Clerk’s action required:

Name of the court. Put the county where the case was filed in the blank after "Superior

Court of Washington County of ."

Case name. Copy this from the order you are trying to enforce.

Case number. When petitioner first files the papers to start the case, the court clerk assigns

a case number. You must put that number on every paper you file with the court and serve

on other parties during the case. Put it number near the top on the right-hand section of

the first page of every form after "No." (abbreviation for “number”) When petitioner first

files the case, she may be able to use a special stamp at the court clerk’s counter to stamp

the case number on each paper. You can print or stamp the case number. If you are filing

your case in the same court that entered the order you want to enforce, use that order’s

case number.

This case type is for a divorce.

Put the county where you are filing this form.

Put the case number. The court clerk assigns this number when

the Petitioner files the case.

This is the form’s title.

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If you do not put the case number on the first page of every copy of everything you file with the court and copies for other parties, your papers may be lost, or the clerk may return them to you. Some courts will fine you for filing incorrect forms.

Title. Each form has a title on the right-hand side under the case number. You might have

to add info to it. Example: On a declaration, you put the name of the person filling it out.

Format: Pleadings (legal forms) you file with the court and attachments to pleadings must follow court rules about size and margins (GR 14(a)). You must use regular size (8 ½ x 11”) white paper. You may write on only one side of the paper. The first page of each paper you file must have three inches of space at the top. Other margins (left, right and bottom, and the top from the second page on) must be at least one inch wide. Use black or dark blue ink. If your forms do not follow these rules, the court clerk may refuse to file them or fine you.

The contents. Fill out each form according to its instructions. In most counties, you may

print or type. It must be readable. You must use BLACK OR DARK BLUE INK. After filling

out each form, re-read it. Make sure you have correctly filled in all blanks needed. Any

corrections must be neat and readable.

Do not write in the margins of any page. The clerk may reject your form.

Dates. On the last page of most forms (not including orders), there is a space for the person

who filled the form out to put the date they signed it. The judge fills in dates in orders

when the judge signs the order.

Signatures.

Your Signature: After you fill out a form, look for the place(s) to sign your name:

Some forms have one signature line for “petitioner” or “respondent.” After filling out a form

such as the petition, sign at the place that applies to you. Look carefully. You may have to

sign in more than one place. You may have to put the date and the place (city, state) you

signed the form.

When you prepare and file motions, you are the moving party. Look carefully for each

place marked “signature of moving party or lawyer.” You may have to sign in more than

one place. You may have to put the date and the place (city, state) you signed the form.

When you prepare an order for the judge to sign, look for the place at the end for your

signature. Check “is presented by me.”

Judge’s Signature: Leave the judge’s signature line and the date blank.

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Other party’s signature: Some forms have a place for other parties to sign. You cannot

force them to sign a court paper. If you have prepared an order after a hearing, the

other party may be willing to sign it if they agree it accurately states the judge’s

decisions, or the judge may require the other party to sign.

Agreed orders. A party who agrees with the orders you have written should sign in the

right place on each court order they agree to.

May be signed by the court without notice to me. If you are the respondent or nonmoving

party, or if you did not prepare the order, the other party may ask you to check this box and

sign underneath. If you do, you are agreeing the judge should sign the order as written

AND the other party can give the order to the judge to sign without letting you know when

they are going to do it.

Other signatures: If a witness or the person serving papers must sign a form, they

must fill out all info correctly and sign in the right space.

Place signed. Declarations and Proofs of Personal Service must include the place you signed

and the date. Example: Signed this 10th day of October 2014 at Seattle, WA.

Identifying Information. Court rules try to protect privacy but also allow public access to

some info in court files. The three boxes discuss these rules.

Protect Your Privacy

Box #1 - Things to Not Put in Most Court Papers:

Court General Rules 22 & 31 try to protect privacy in family law cases. Almost all pleadings, orders, and other papers filed with the court are available to the public. They may also be publicly available online. Except where instructions about a specific form say otherwise (example: the forms in Box #3), use these rules for papers you file with the court.

Address (Where you live) and Phone Number: Put an address where you can get mail from the court. It does not have to be your home address. You should also give the court a phone number where they can reach you.

Social Security/Driver’s License, ID Numbers of Adults and Children: If you put these in court papers, put only the last four digits.

Bank Account, Credit Card Numbers: Put the bank name, type of account (savings, checking, and so on), and the last four digits of the account number.

http://www.courts.wa.gov/court_rules/?fa=court_rules.display&group=ga&set=GR&ruleid=gagr22


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Box #2 - Private Info to File With Sealed Cover Sheets:

If you use a sealed cover sheet, this info is usually available to the other party and the court. It is not available to the public.

Financial Information: You must attach any paystubs, checks, loan applications, tax returns, credit card statements, check registers, W-2 forms, bank statements, or retirement plan orders you file to a Sealed Financial Source Documents form. Then the public cannot access them.

Medical or Mental Health Records or Information: You must attach papers you file with info about someone’s past, present, or future physical or mental health, including insurance or payment records to a Sealed Personal Health Care Records form. Then the public cannot access them.

Confidential Reports: Reports intended for court use must have public and private sections. You attach the private section to a Sealed Confidential Reports Cover Sheet.

Retirement Plan Orders: Certain retirement info belongs in the public file. “Retirement Plan Orders” do not. Use the Sealed Financial Source Documents Cover Sheet for the Retirement Plan Order. See GR 22, or see a lawyer if this affects your case.

Other Kinds of Confidential or Embarrassing Info Not Mentioned Above. If the paper you want kept confidential is not in the above list, you may need to file a motion to have that paper, or part of it, sealed under General Rule (GR) 15. There is no packet for this. Talk to a lawyer.

Box #3 - When to Put Private Info in Court Forms:

These are not in the public file. Info in them is usually not available to the other party.

You must fill in your personal info completely (including your home address, social security number and so on):

Confidential Information Form

Vital Statistics Form

Domestic Violence Information Form

Law Enforcement Information Sheet.



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Part 6. How to fill out each required form

A. Motion for Contempt Hearing – FL All Family 165

This form

explains why the person is in contempt

shows your requests to the court

Caption. Fill out the caption.

1. Check the box showing which party you are.

2. In the first blank, put the other party’s name. In the second, put the date the court

entered the order the other party has violated. In the third, put that court’s county and

state. Then check the boxes and fill in the blanks that apply. If you check child support

order, you must check all boxes underneath that apply.

3. Request. Do not make any changes to this section.

4. Money judgment requested. Check the first box and skip to 5 if you do not want a

money judgment. Otherwise, check the second box. Then check all the boxes underneath

and fill in boxes as appropriate to show what you want.

You must put the dates for which the support, maintenance, or other obligation is due. If

DCS has tried to collect support for you, or if anyone in your family gets TANF, DCS can give

you this info.

5. Fines and penalties requested. Check the first box and skip to 6 if you do not want the

judge to fine or penalize the other party. Otherwise, check the boxes that apply.

Courts usually only order jail time in serious cases, or where it has previously found the

person in contempt. If you ask for imprisonment, and the other party cannot afford to hire

a lawyer, they are entitled to a court-appointed lawyer at a hearing that might result in jail.

As the party making the motion, you are NOT eligible for a court-appointed lawyer.

6. Other orders requested. Most people will not put anything here.

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Person making this motion fills out below. In the first blank, put where you are signing

this form. In the second blank, put the date you are signing. Sign and print or type your

name where it says.

B. Order to go to Court for Contempt Hearing - FL All Family 166

The court will sign this to schedule your contempt hearing.

Caption. Fill in the caption.

1. Findings.

2. The court orders. Print the other party’s name. Leave the date, time, place, and

Room/Department lines blank, unless the court clerk or facilitator gives you a specific date.

The judge usually fills in this part.

If you have a choice about the hearing date, choose one that gives you enough time to have

the other party served. (Example: Your county requires six court days’ advance notice to

the other party of a hearing. You are not sure you can have the party served immediately.

You set the hearing date fourteen days away to give your server enough time to complete

service of process.)

3. Other orders (if any). Leave this for the judge.

Presented by: sign your name above Signature. Print your name on the next line.

C. Notice of Appearance – FL All Family 118

You use this to tell the other party where they should send you notice about the case.


1. Print your name.

2. Do not make any changes to this section.

3. If you are afraid to give your mailing address, use an address where you will know

immediately if papers arrive about your case.

Date the form and sign where it says Sign Here. Put the date.

If the mailing address you use in the Notice of Appearance later changes, you must file a

Notice of Address Change, FL All Family 120, available at courts.wa.gov/forms. You must

http://www.courts.wa.gov/forms

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also provide the other parties a copy. Use the Proof of Mailing or Hand Delivery form, FL

All Family 112, and procedure2 to show you have given notice.

D. Contempt Hearing Order After Contempt Hearing - FL All Family 167

Your county may require you to do these things before the hearing:

prepare a “proposed order”

give the other parties a copy of it

Deliver a copy of the proposed order as part of the working papers

Take a blank copy of this Order with you to court.

If you prepare a proposed order before the hearing, use the info in your Motion to help you

state what you want the judge to order. Fill out the Order to show how you want the judge

to decide.

Otherwise, you fill this out to put the judge’s decision in writing. Usually the person who

wins at the hearing presents an order for the judge to sign at the contempt hearing.


If the court entered a judgment or set a review date, check Clerk’s action required.

1. Money Judgment Summary. This section is a summary of money judgments. This

might include money owed for back support, attorney's or GAL fees.

Check the first box and skip to 2 if you are not entering a money judgment. Otherwise,

check the second box. Come back after filling in section 8. When you do, fill in this section

to reflect what you put in 8. In the blanks for from … to… directly under any box you

check, put the dates the money is owed for.

2. In the blank, put the contempt hearing date.

3. Support payments. Check the first box if and skip to 4 if the hearing did not cover child

support issues. Check the second box if no one is violating the child support order. Check

the third box if the judge found one of you in contempt on child support issues. In the first

blank, put the person violating the support order. In the next blank, put the date of the

support order. Check all the boxes immediately underneath that apply.

2 The Proof of Mailing or Hand Delivery form, FL All Family 112 and instructions for it are in the Responding to a Motion for Contempt packet. It is not in this packet.

http://www.washingtonlawhelp.org/resource/responding-to-a-motion-for-contempt-in-a-fami?ref=U18CB

http://www.washingtonlawhelp.org/resource/responding-to-a-motion-for-contempt-in-a-fami?ref=U18CB

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a. Ability to follow orders in the past - Check the box that applies. (If this is a

proposed order, in the blanks explain the party’s past ability to comply.)

b. Ability to follow orders now - Check the box that applies. (If this is a proposed

order, in the blanks explain the party’s past ability to comply.)

4. Parenting Plan, Residential Schedule, or Custody Order. Check the first box and skip

to 5 if the hearing did not cover custody or parenting issues. Check the second box if no one

is violating such an order. Check the third box if the judge found one of you in contempt on

parenting or custody issues. In the first blank, put the person in contempt on those issues.

In the next blank, put the date of that order. Then check all the boxes immediately

underneath that apply.

a. Ability to follow orders in the past - Check the box that applies in your case. (If

you are writing a proposed order, you check the first box.)

b. Bad faith – If this is your proposed order, check the first box. Otherwise, check

the box showing what the judge ordered.

c. Ability to follow orders now - Check the box that applies in your case. You ought

to be able to check is not able. (If this is a proposed order, in the blanks explain the

party’s past ability to comply.)

5. Restraining Order or Other Order. Check the first box and skip to 6 if the hearing did

not cover a restraining or other order. Check the second box if no one is violating the

restraining or other order. Check the third box if the judge found one of you is in contempt

of such an order. In the first blank, put the person in contempt of the order. In the next, put

the date of the restraining or other order. Then check all the boxes immediately

underneath that apply.

6. Lawyer Fees and Costs. Check the first box and skip to 7 if the hearing did not cover

lawyer fees and costs. Check the second box if the court ordered payment of lawyer fees

and costs.

7. Contempt. Put the name of the party who was the subject of the contempt hearing.

Check the box showing what the judge ordered.

8. Money Judgment. Check the first box and skip to 9 if the hearing did not cover any

money judgment. Check the second box if the judge ordered a money judgment. Then check

all the boxes underneath and fill in the blanks showing what the judge ordered. In the

blanks for from … to… directly under any box you check, put the dates the money is owed

for.

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9. Make-up parenting time. Check the first box and skip to 10 if the hearing did not cover

this. Check the second box if the court ordered make-up parenting time for someone. In the

first short blank, put who that is. Under that, put the dates and times.

10. Jail time. Check the first box and skip to 11 if the hearing did not cover this. Check the

second box if the court ordered jail time for someone. Fill in the blanks that follow. Check

the first box immediately underneath that if the judge is suspending jail time and put why

in the blank. Otherwise, check jail time starts and fill out the rest of the section.

11. Contempt can be corrected if. Check the first box and skip to 12 if the judge did not

find the person in contempt. Check the second box if the judge found contempt. Then, in

the blanks, put who is in contempt, and how the judge said the person could purge (get rid

of) the contempt. Examples: the judge might have ordered payment of support, attending

all review hearings, notifying the court of job searches, and so on.

12. Court review. Check the first box if the judge did not order a new hearing. Check the

second box if the judge ordered the parties to return to court later to see if everyone is

obeying the order. Put the date and time of the next hearing.

Ordered. LEAVE THIS FOR THE JUDGE.

Petitioner and Respondent or their lawyers fill out below:

There are two columns of boxes to check, one column for each party. You should is

presented by me. You sign and print your name and the date where indicated.

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Part 7. How to fill out forms you may need

A. Declaration of: – FL All Family 135

Use this if other people are giving evidence to help prove the other person is in contempt;

or, after getting the other party’s response, to add more evidence of your own or from

another person.

A Declaration is a statement, sworn to be the truth under penalty of perjury, by anyone

with direct knowledge about the issues your motion covers. This could include family

members, friends, teachers, counselors, or anyone else who has directly seen, heard, or

otherwise witnessed important events in your case.

The declaration should give the important facts this person adds to your case. Remember:

at your hearing, you will not have much time to speak. The judge may not let you add facts

in your case. You must explain all the important facts on the forms you file with the court.

Some courts require allow live testimony. Others allow it on request. Others consider

only written evidence. Find out your county’s practice. If your county or allows it and

someone has requested it, you must have your witnesses present in court the day of the

hearing.

By presenting a declaration from a witness, you may be giving up the right to keep confidential other info that witness may have about you or the children.

1. Some brief rules about witness Declarations

The person making the declaration is the Declarant.

Put the most important points at the start. Less important points should come later.

The declarant should base their statement on their own personal knowledge (what they saw

or experienced firsthand), not what someone else told them. Exception: the declarant may

talk about what another party has said.

The declarant should explain how well they know you or the people they are writing about,

how often they see the people, and in what situations. Example: “Mr. Jones has worked for

me at Acme Plumbing for 15 years. I see him almost every day at the office. Also, because our

sons are on competing soccer teams, I have seen him coaching his son’s games three or four

times this season. He has invited me into his home a two or three times for dinner with his

family over the years I have known him.”

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The writer must type the declaration or print it neatly in black or dark blue ink. (A few

courts require typed declarations.) If the declaration is hard to read, the judge may not try.

Do not make the declaration too long.

Stick to issues the judge will be deciding. Be specific on those issues.

In a parenting dispute, general statements, such as “she is a bad mother,” or “the

children are much happier now living with Mary,” are not helpful. The declaration

should describe specific things, and state when and where incidents occurred.

Example: “I live on the same street as Joe. About a year ago, Joe knocked over our

mailbox while driving. I ran out to the street to see what had happened. Joe was

standing next to his car. I smelled liquor on his breath. I have seen him weaving

down the road in his car three other times this year.”

In a child support dispute without parenting issues, the statement above may not be

relevant to the issues before the court. If it is not relevant, do not include it.

Attach extra pages to the declaration if you need more space. Extra pages should also have

margins of at least one inch. You should number all the pages at the bottom.

Some courts limit the number of pages you can file with a motion. Check local rules, or ask

the court clerk or facilitator.

If you attach documents to declarations, such as printouts of bills, school records, medical

or treatment records, police records, and so on, refer to them in the declaration and call the

attached documents exhibits and number them Exhibit Number 1, Exhibit Number 2, and

so on.

If the papers you are attaching do not require a sealed cover sheet (see the General

Instructions section), staple them to the declaration.

If the papers you are attaching have personal medical or mental health info, or

financial records, or confidential court reports, put an exhibit number or letter on

each paper you are attaching. When the declarant mentions that paper, they should

use that exhibit number or letter and put it is “filed with the Sealed Personal Health

Care Records cover sheet on _______________ (date).” Do not staple the paper to the

declaration. Attach it to the appropriate Sealed Cover Sheet form before you file and

serve it. We describe the sealed cover sheet forms elsewhere in this packet. See the

General Instructions section about what to keep out of the public file.

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2. Filling out the Declaration form

Caption. Fill out the caption and make as many copies of this form as you will need before

adding any other info. Then you will have blank forms with just the caption on them. You

may give a copy to each witness to fill out and have one for you to use, where necessary.

On the right side of the caption, after declaration of…, put the declarant’s name. Do the

same next to Declaration of under the caption.

1. In the first blank, put the declarant’s name. In the second age, put the declarant’s age.

Check the box showing who the declarant is. If you check other, explain in the blank

(examples: “petitioner’s friend,” mother’s counselor,” “child’s daycare provider”).

2. I declare. The declarant should type or print neatly in black ink the info they want to tell

the judge. (A few courts require declarations be typed.) Follow the suggestions in section a.

I declare under penalty… The declarant must check the box and put the number of pages

they are attaching if the declaration is longer than two pages.

Signed at. The declarant puts the place and date they are is signing this declaration. Underneath, they sign and then print their name.

B. Confidential Information Form and Attachment - FL All Family 012

In family law cases, you must give the court your address and phone number, your social

security number, date of birth, driver’s license, and your employer’s name and address, as

well as certain info about the other people involved in the case. RCW 26.23.050(5)(l) &

(7); GR 22(g) & (h).

Fill this out. File it with the court clerk. Keep a copy for yourself. Do not serve this on the

other parties.

The Confidential Information Form is normally not available to the other parties or their

lawyers. The form could go to DCS and other parts of DSHS (Washington State Department

of Social and Health Services). They may release info in this form to another party. Another

party could get access to this form by following certain court procedures.

When your address changes, you must update the court by filing a Notice of Address

Change, even after your case is final. If you do not, legal papers may go to you at your old

address. The court may enter orders against you without actual notice to you. RCW

26.23.055(2) & (3).

1. Put your name. Put the county where the case is filed and the case number.

http://apps.leg.wa.gov/RCW/default.aspx?cite=26.23.050





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2. Check yes if restraining order protection orders are in place. In the blank, put who

the orders protect. If the orders go into effect later, you must file an updated form.

Check no and skip to 3 if there is no restraining order or protection order in place.

3. Check the first box if you believe the safety of an adult or child would be at risk by

listing your home address. In the blank, explain why.

4. Your Information: In the first table, put the info requested, including your driver’s

license number and social security number, if you have these. Skip the second table.

5. Other Party’s Information: In the first table, put as much of the info requested as

you can. Skip the second table. Use the Attachment to Confidential Information if

there is more than one respondent.

6. Children’s Information: Put as much of the info requested as you can.

7. Have the children lived with anyone other than… Check no and skip to 8 if the

children have only lived with petitioner or a respondent in the past five years. Check

yes if the children have lived with someone else. Put the info requested.

8. Do other children (not parents)… Check no and skip to 9 if only the petitioner and

respondents have custody or visitation rights. Check yes if other people have these

rights. Put as much of the info requested as you know.

9. If you are asking for custody and are not the parent… List any other adults living

in your home. Use the Attachment if there are more than two.

10. Sign and date the form and put where you signed it.

C. Sealed Personal Health Care Records (Cover Sheet) –FL All Family 012

Unless a local procedure requires otherwise, you must use this whenever filing anything

with the court that mentions any kind of mental or physical health care, health insurance,

or medical bills, to make sure the records are not available to the public. Some of the

papers you should use this cover sheet for are:

Medical/mental health records and bills

Letters/declarations from doctors and counselors

medical bills and statements of medical coverage (or denial)

cost estimates for medical care

social security and L&I and other disability program letters and records

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medical evaluations

medical insurance records

dental records

records of alternative health care practitioners such as massage therapists,

acupuncturists or chiropractors

genetic parentage testing

Put this cover sheet on declarations that mention medical or mental health conditions.

Keep a blank copy of this. You might need to file more health care records later.

Attach the confidential personal health care records to this form.

Fill out the caption. Check the boxes showing what type of records you are attaching.

Submitted by: Check the box that applies to you. In the blanks, sign and print your name.

D. Sealed Confidential Reports (Cover Sheet) – FL All Family 013

This is for some confidential reports filed with the court, including the following when

intended as reports to the court in a family law case:

Parenting evaluations

Domestic Violence Assessment Reports created by certain qualified people

CPS reports

See the form for other types of reports

The person preparing the report must also file a public portion listing the materials or info

reviewed, people contacted, tests conducted or reviewed, and conclusions or

recommendations reached.

Instructions for the Sealed Reports form:

1. Caption. Fill out the caption.

2. Check the boxes next to the type of report.

3. Attach the confidential part of the report to this form. If you are afraid for your

safety or the children’s safety, block out any info identifying place and address on

the copies you file with the court and deliver to the other parties.

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4. Submitted by. Check the box that applies to you. In the blanks, sign and print your

name.

E. Sealed Financial Source Documents– FL All Family 011

You must use this when filing private financial documents with the court. Keep a blank

copy in case you must file more documents later. You can attach one form to a stack of

documents.

1. Caption. Fill in the caption.

2. Check the boxes next to each type of paper you are filing. If you are submitting

child support worksheets, their instructions say what papers to file.

3. If you are afraid for your safety or the children’s safety, you can block out info

identifying your location on the copies you file with the court and give the other

parties.

4. Submitted by. Check the box that applies to you. In the blanks, sign and print your

name.

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Part 8. How to file forms with the court

After filling out the forms, you must

file them with the court

ask the judge to sign your Order to Go to Court for Contempt Hearing

have the papers served on the other parties

This section explains these steps. Before filing and serving your papers, make sure you

have filled out the forms you need.

A. Filing your Motion with the Court and Asking the Judge to Sign Your Order

You must file your Motion and have the Order to Go to Court for Contempt Hearing signed

by the judge (and filed with the clerk) before serving the other party.

You will need a certified copy of the order you are trying to enforce. If the court where you

are filing your motion entered that order, get a copy when you file your papers. If it was a

different court, get the certified copy in advance. (Note: We only explain how to file a

motion for contempt in the county that entered the order you now want enforced.)

Make at least two copies of everything, including the proposed orders and the order

you want enforced. One copy is for the other party. One is for you. Exception: make

only one copy of the Confidential Information Form and attachment, and do NOT give it

to the other party. If there is more than one other party to your case, or you must give

the judge working papers, make more copies.

You must include everything. Depending on your case, you will need at least

o Motion for Contempt Hearing

o Order to Go to Court for Contempt Hearing

o each witness’s declaration

o a copy of the order you want enforced (put the certified copy of it into the

packet for the party in contempt)

o Notice of Appearance

o a proposed Contempt Hearing Order After Contempt Hearing, if required

o Confidential Information Form and Attachment, if your information has

changed since you last filed this form (do not serve this form)

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Make full sets of your forms (one set of originals and sets of copies). Organize your

forms into sets by placing all the originals in one set and making sets of copies.

o The set of originals will be for the court.

o One set of copies is for you. Put the Confidential Information Form and

Attachment copy in your set.

o Other set(s) are for other parties. Put the certified copy of the order you

want enforced into the set for the party you believe is in contempt.

o Make sure each set includes the appropriate forms.

Call the Superior Court Clerk or Family Law Facilitator to find out where to get your

Order to Show Cause signed by the judge, and what days and hours.

Go to the courthouse courtroom number at the time given to you by the clerk.

Look for a clerk or bailiff so you can sign in. This is usually someone sitting at a desk

near the judge. Give the clerk the set of originals of your papers. Sit down to wait for

your turn. When they call your case name, tell the court you are there. When they tell

you to come forward, tell the court you want an Order to Go to Court for Contempt

Hearing. The court may ask why you believe the other party is in contempt and how

you have already tried to have them follow the order. If you think that you will be

nervous, try beforehand to make a list of what to say. Have it with you when you talk to

the judge. You will have only five to ten minutes to explain why you need the order. Be

prepared. The judge may make changes to your order, and then sign it. The judge

should then give you all your papers back, including the signed order.

Go to the court clerk’s office to file your original papers and get conformed copies.

Make at least one copy of the signed Order to Go to Court for Contempt. Ask the clerk

to stamp your copies of the other papers you are filing (motion, declarations, and

so on) to show the date you filed the originals of your other forms and to show the

judge’s signature on the order. Take the stamped copies back from the clerk. The clerk

keeps the originals.

Ask the clerk to file the originals of all your papers except ask the clerk where to

deliver the proposed order (Order after Contempt Hearing). In some counties, the clerk

takes the proposed order. In others, you deliver it to a different office, or they may just tell

you to bring it to the hearing. (Signed orders are different. You must always file signed

orders with the clerk.)

If you need to deliver working papers for the judge for your upcoming hearing, try to

do that before you leave the courthouse.

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Part 9. How to serve forms

After filing your papers, you must have them properly served on (delivered to) the other

parties. The court does not serve the other parties. You must arrange for service and

make sure your server delivers the papers properly. Do not serve the papers on another

party yourself. Follow the rules for service carefully. If you do not, your court orders

could be set aside, even years later.

Who to serve: Every other party in the case. If your case is ongoing (the court has not

entered final orders yet), and the other party has a lawyer, serve the party as we explain

later, and provide an extra courtesy copy of the papers to the party’s lawyer. Remember

also to serve the state, if it is a party, and any GAL or evaluator in your case.

What to serve: You must have all the papers you filed served except the Confidential

Information form and attachment, if you have filled these out.

How to serve: You must arrange to have someone else personally the papers. We explain

how below.

Our Serving Papers on the State packet describes how to serve the state, if it is a party.

When to serve: You must have your papers served in time to give the other parties the

advance notice your county requires. When counting, do not count the day of service,

weekends, or court holidays. Many counties require more than five court days’ notice. You

must serve all the parties before your county’s deadline.

How to copy your papers for service

Be sure you have the necessary copies of the papers. Make any extra copies you need so

that you have:

_____ One set for you

_____ One set for each other party (1 x ____ number of other parties = ______) except

you do not serve the Confidential Information Form and attachment (if you

have prepared this form) on any other parties. The copies of the Order to Go

to Contempt Hearing must have the judge’s signature and date of filing


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_____ one set for the judge if you need to or choose to deliver “working papers”3

_____ one set for the State (if you are serving the State)

_____ One set for the Guardian ad Litem, if there is one in your case

_____ Total = This is how many copies you need of each document

Organize the papers:

1. Organize the forms into sets. Each set should have a copy of each form you have

filled out, except for any Confidential Information form and attachment. Do not give

those to any other party.

2. Check each set. Be sure you have the forms you need.

3. Keep a full set of copies for yourself. Put any Confidential Information form and

attachment into the set you will be keeping,

4. Put the certified copy of the order you are trying to enforce into the set for the party

you believe is in contempt.

5. Put each of the other parties’ sets of papers in an envelope, addressed to that party,

with your return address.

A. Instructions for Personal Service in Washington

You must carefully follow the rules for having the other parties personally served.

You cannot serve the documents on the other parties yourself. You must get someone

who is 18 or older to serve for you.

If you have the money, hire a professional process server. The cost of a professional

process server or sheriff is usually $30-$80. A professional process server may be better. The

sheriff may not be willing to try to serve again if someone was not at home the first time.

Ask an adult friend to be your process server. If you cannot afford a process server or the

sheriff, any competent adult 18 or over who is not a party to the case can serve for you. Your

server must understand how important it is to serve the papers and correctly fill out the proof

of service form. If you do not serve the other parties properly, your court orders could be

set aside, even years later.

3 You should always make a copy for the judge. Even if the local court does not require you to give the judge working papers, take the papers with you to your hearings. Sometimes the judge does not have the case file in the courtroom, or papers you have filed with the clerk have not yet been placed in the court file.

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If you are using an adult friend as server, let the friend know it is best to put the papers in

the other party’s hand. But the other party may refuse to accept the papers. Encourage your

server to use her best judgment about how to leave the papers. Here are some examples of

common situations in service.

Example 1: The other party may be expecting you to serve them, and is avoiding

people who look like servers. In this case, your server can pretend to be delivering

an innocent package.

Example 2: The other party may let your server in, but refuse to take the papers.

Your server should always try to hand the papers to the server, unless it would be

unsafe for the server to try to do so. It may be okay for the server to leave the papers

on the floor in the other party’s home.

Example 3: The other party opens the door for your server. The other party does

not let your server in. The other party refuses the papers. It is okay for your server

to leave the papers in the doorway or just outside.

Example 4: The other party may be home, but refuses to get the door when your

server knocks. Your server may have to make a few such visits before you can ask

the court for help. Tell your server DO NOT LEAVE THE PAPERS OUTSIDE.

Give your server the envelope of papers you prepared for service on the other party, with

the other party’s home and work address, a physical description of the other party, and any

other information to help the server find the other party.

Give your server a Proof of Personal Service form to fill out and return to you once service

is complete. (Some process servers have their own Proof of Service form they will use

instead.)

Your process server should hand the papers directly to each party. Your server may

hand the papers to each party at home, work, or anywhere else they find the person. If the

State of Washington is a party, use our Serving Papers on the State packet.

If a party other than the person in contempt is home, your process server may do

“abode service”: delivering the papers at the party’s home to any competent adult

who lives in that home with the other party. If your server does this, your server should

ask that person for their name and age, if they live at that address, and if the other party

also lives at that address. Abode service on the party in contempt may not be allowed

under local court rules or be enough to allow for criminal enforcement of the order

to show cause.

If your family law case is pending when you serve your contempt motion and the court has

not yet entered a final order, and the other party has a lawyer, you should serve both the

http://www.washingtonlawhelp.org/resource/how-to-serve-papers-on-the-state?ref=teiAL

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party and lawyer. Have your server leave a set of the papers at the lawyer’s office. In this

case, it is enough to hand the papers to another worker in the office.

The process server must complete a separate Proof of Service form for each party

served. After serving the papers on a party, your server must sign a Proof of Service for

that party and give you this form. You then file it with the court clerk to prove you had the

papers delivered properly.

If the other party is served outside the State of Washington, you may need to follow other

procedures not explained in this packet. Talk to a lawyer.

1. Filling out the Proof of Personal Service – FL All Family 101

Your server must fill out a separate Proof of Service for each party served. After your server

completes service and signs the Proof of Personal Service form(s), follow the our

instructions for filing this form.

Caption. Fill out the caption.

1. In the blank, put your name.

2. Personal Service. In the blank, put the name of the party being served. The server must

check the box that applies.

3. The server should put the date, time and address where she served the papers.

4. List all documents you served. Check the box to the left of each form served on that

party. Sometimes you must fill in a blank to describe a form. Example: if you check

Declaration of, put who wrote the declaration. If you had the other party served with any

forms not listed, check other and put the names of those forms. You MUST list all the forms

that were served on the other party. If you leave something off your list, you will have no

proof the other party received it.

5. Fees charged for service. Check the box that applies. Usually, only professional servers

will use the box for fees and mileage.

6. Other information. Your server may put more info here. Example 1: Your server tried

several times to serve the other party. She is never home or the server cannot find her. The

server should put here the dates and times and descriptions of each time the server tried to

serve the other party. Example 2: The server gave the papers to an adult living with the

other party who would not give his name. The server should put here what the person who

received the papers looks like.

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Signed at. The server should put the city and state where she signed the form and the date

she signed. She should sign where it says Signature and then print or type her name where

it says.

2. Filing Your Proof of Service

Gather your original signed Proof(s) of Personal Service. Have one for each of the other

parties. Make one copy of each original. Take the originals and the copies to the court

clerk’s office. Give the clerk the originals. Ask the clerk to stamp the date of filing on your

copies. Keep the copies in a safe place. Take them with you to your hearing(s). You may

need them to prove to the judge that you served the other party.

B. If you do not serve the other parties on time

You should still get ready for and go to the hearing. If the other party appears and does not

object to holding the hearing on that date, the court may go ahead with the hearing. If the

other party shows up and objects to the hearing, ask the court to delay or postpone

(“continue”) the hearing to a later date.

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Part 10. Getting Ready for Your Hearing

A. Working Papers and Confirming Your Hearing

In many counties, you must:

Deliver an extra copy of all of papers (including proposed orders) for your

hearing for the judge to read. We call this set of copies Working Papers or Working

Copies. Read What are Working Copies?

Confirm the hearing a few days before the hearing date. “Confirming the hearing”

means telling the court the hearing will take place as scheduled.

To learn the rules for working papers and confirming the hearing in your county, read local

court rules, and check with the Family Law Facilitator or court clerk.

If you do not give the judge working papers and do not confirm your hearing in a county that requires this, the judge may cancel your hearing or might not consider any of your papers.

1. Replying to the Other Party’s Response

The other party should respond in writing to your motion before the hearing. In most

counties, the other party must deliver a response to you and the court no later than one

court day before the hearing. Even if the other party sends no response, go to the

hearing. If the other party comes to the hearing, tell the judge the other party did not

respond in time. The judge may decide not to consider the other party’s papers, or go ahead

with the hearing, or put the hearing off to a later date.

If the other party responds, read the response carefully. If you get no chance to file a

written reply, be ready to tell the judge verbally why you disagree with the response.

Filing a Reply: If your county lets you file a written Reply to the other party’s response

(not all do), use the Declaration form to write it. Put Declaration of (Petitioner or

Respondent) In Reply under the title of the declaration form. In your declaration, state

which points in the other party’s response you disagree with, and why. If you need to, give

the court more papers or declarations from other witnesses in reply to evidence the other

party has given.

http://www.washingtonlawhelp.org/resource/what-are-working-copies?ref=YkoWK

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After finishing your declaration, make a copy of it (and every other paper you need to reply

to the other party’s response) for each of the other parties, yourself, and the judge (if you

need working papers). File a set of the papers with the court clerk. Have the clerk stamp

the copy you keep, so you can prove when you filed it. Deliver a set of the papers to each of

the other parties (and to the judge if you need working papers). You must file and serve

the papers by the deadline for your reply. Check with your Family Law Facilitator, court

clerk, or local rules for the Reply deadline. If you do not serve your reply by the deadline,

the judge may not read it.

2. Going to the Hearing

Live testimony (also called oral testimony): If a party has requested live testimony in a

county that allows it, or your case is in a county requiring live testimony at all contempt

hearings, you and your witnesses must be at the hearing. The court may not consider

written statements in declarations. It may require the witnesses to testify in person.

If the court will not use live testimony, make sure you have filed and served all your

written evidence in advance.

Some counties require live testimony. Others may not allow it at all, or allow it only with advance court order. Learn your county’s practice.

If the Other Party Gets a Lawyer: If at any time before the hearing another party’s

lawyer contacts you, or shows up at a hearing, you may decide to get one yourself. If

so, tell the lawyer and the court you need to postpone (continue) the hearing. Do not

panic. The lawyer may ask you to sign some documents. Do not sign anything you

do not understand. If you asked the court to send the other party to jail for

contempt, and she is low-income, she may get a public defender to represent her at

the contempt hearing. The public defender may appear on the day of the hearing for

the first time.

Get Ready for the Hearing. Try to go to court before the day of your hearing. Watch

how the court generally does hearings. Try to make some notes to yourself about

the main points to make at your hearing.

Get to Your Hearing Early. Try to dress neatly. Try to bring a pad of paper and

black or dark blue pen to write notes. Bring your set of the papers, and your copies

of any papers the other parties gave you in response. Do not bring your children. If

you are not there on time, the judge may cancel the hearing (or the other party may

win). Make sure you bring along any proposed Order after Contempt Hearing you

have prepared. Bring a blank Order too.

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When You Get to the Courtroom. Tell the person in charge in the courtroom (the

clerk or bailiff) your name, and your case name and number. Take a seat. Stand up

when the judge walks in the room. When they call your case name, tell the court you

are there. Stay in court until they call your case for hearing.

If the other party does not show up, and you had the other party properly

served with the contempt papers, the court might order a bench warrant

issued for their arrest. You may ask for this if you still want to pursue your Motion

for Contempt.

Presenting Your Case. If the other party shows up at the hearing, each of you will

have a chance to tell your side of the case. Stand while speaking. Talk directly to the

judge. Tell the judge briefly what you want and why. Try to keep your argument

short and only outline your main points. The judge probably will have read your

papers before the hearing. Do not repeat everything in your papers. Try to make

notes to use at the hearing. If the court allows live testimony, have your witnesses

ready to testify. Read Getting Ready for a Hearing or Trial.

DO NOT INTERRUPT THE JUDGE.

Hearing the Judge’s Decision. After the judge has heard both sides, the judge will

decide on your requests. Listen carefully. Take notes. Show the judge the Contempt

Hearing Order after Contempt Hearing if you have prepared one. The judge may

make changes to the order you prepared, or may direct you, the other party, or the

other party’s lawyer to do it or to write a new Order. If the other party’s lawyer

makes changes to the Order, read them carefully. Make sure they say what the judge

said. If you are unsure about any changes, do not sign the Order. Ask the lawyer to

go back before the judge to make sure the Order says what the judge said. Usually

you want your court orders signed the day of your hearing. Some counties

require they be signed before the parties leave the courthouse.

Getting Copies of the Orders. Make sure you get a copy of the Contempt Hearing

Order after Contempt Hearing as signed by the judge. Ask the clerk how to do this.

The clerk may give you the originals and tell you to go make copies in the library or

at the clerk’s office. DO NOT LEAVE THE COURTHOUSE WITH OR CHANGE OR

DESTROY COURT ORDERS THE JUDGE HAS SIGNED. If you do not know what to do

with the originals, ask. Make sure the other parties to your hearing also get a copy

of the Order.

What if the Judge Schedules a Review Hearing? It is common for a judge to give

a party in a contempt motion another chance to obey the court’s orders. The judge

may order the party to do certain things, and then set a “review hearing” several

weeks in the future. You must get ready for your review hearing the same way you

http://www.washingtonlawhelp.org/resource/basic-tips-on-how-to-prepare-for-a-court-hear?ref=Us9Bh

3108EN | May 2019


got ready for the Motion for Contempt. This may include filing and serving a

declaration before the hearing about whether the party has done what the court

ordered, preparing working papers, or confirming the hearing. If you are not sure

how to get ready for the review hearing, talk with a lawyer or your Family Law

Facilitator well before the next hearing date.

3. If you Disagree with the Court’s Order

Your options are limited. If a court commissioner decided the motion, and you do not want

to try to give the commissioner more evidence, you may file a Motion for Revision. A judge

hears a motion for revision. That judge can hold a “new hearing” on the same evidence that

the commissioner considered. You have ten days from the date the court commissioner

signed the order to file a Motion for Revision. RCW 2.24.050. Local court rules may require

you also to serve the other parties within the same deadline. If you plan to serve by mail,

mail your motion at least three days earlier. Motions for Revision are not usually easy to

win. Talk with a lawyer, if possible, before filing one. Our File for Revision in a Family Law

Case packet has forms and instructions.


http://www.washingtonlawhelp.org/resource/filing-a-motion-for-revision-in-a-family-law?ref=UwUXC

http://www.washingtonlawhelp.org/resource/filing-a-motion-for-revision-in-a-family-law?ref=UwUXC

3108EN | May 2019


Part 11. Words you should know

Attachment: A document stapled to a court form and referred to in the form. Attachments

should follow format rules for court forms. See basic info about format rules in the General

Instructions of this packet.

Bailiff: The member of the judge’s staff in charge of courtroom procedure and security.

Can be the same person as the clerk.

Calendar: The court’s schedule of cases to be heard; also called a Docket.

Caption: A legal document’s heading. It has the court and parties’ names, the case number,

the name of the document itself, and sometimes, the type of case.

Certified Copy: A copy of a document from the court file made by the court clerk. It has an

official stamp on it stating it is a true copy. Usually, you must pay for a certified copy.

Confirm a Hearing or Trial: Notifying the court that you still plan to have the hearing or

trial scheduled in your case. How to confirm differs by county. Not all counties require it.

Often you must confirm a trial or hearing with a phone call to the court a few days before

the hearing or trial. Local rules explain each county’s requirements. If notice is required

and you do not give it, the court may cancel the hearing or trial.

Conformed Copy is a copy stamped with the date you filed it with the court. A copy of a

court order must also have the name of the judge who signed it printed or stamped on it.

Continuance: Delaying your court hearing to a later date. In your county, the judge might

have to approve any request for a continuance.

Declaration: A written statement made to the court under oath.

Default: The failure to respond to court papers within the legal deadline

Docket: The court’s schedule of cases it will hear on a particular day.

Exhibit: Documents, records, and photos introduced into evidence at trial or hearing. If

attachments to legal forms are exhibits, they should follow format rules for court forms.

(The General Instructions section of this packet has more about format rules.)

3108EN | May 2019


Ex Parte: Going before the court without notifying the other party, or giving them very

little notice. Can also refer to the courtroom where you see a judge without notifying the

other party.

Hearing: Going before a judge to request a court order or to defend against another party’s

request. Hearings usually take place before the trial date and concern specific issues for

example, temporary relief. Often at a hearing the court limits or does not allow live

testimony. Instead, you file and serve written materials in advance.

Jurisdiction: The court’s authority to make decisions about certain people and issues. A

court that does not have jurisdiction does not have the authority to make orders over the

person or subject affected.

Motion: A formal request to the court for an order.

Motion Docket: The court’s schedule of motions it will hear.

Notice of Appearance: A paper you file with the court and serve on the other parties

showing you will take part in the case and saying where to send you papers about the case.

Personal Service: Having someone age 18 or over who is not a party to the case hand the

other party the papers, or, in some cases, to another competent adult who lives with the

other party at their home.

Petition for contempt: The document starting a court case when the order you want

enforced is from an administrative agency or another county. We do not discuss this type

of cases. If this is your situation, talk to a lawyer.

Proposed Order: A document you will be asking the judge to sign. In many counties, you

must file and serve proposed orders with motions or responses to motions to show how

you want the court to decide the motion. Even where not required, we recommend you do

this anyway. A proposed order becomes an order if the judge signs it.

Pro Se: Acting without a lawyer; representing yourself in court.

Public Defender: An attorney paid by the State to represent low-income people in certain

kinds of criminal cases, and some civil contempt cases.

Response: A formal written answer to a Petition filed with the court. Can also describe the

papers you files in response to a motion. It can be confusing.

Restraining Order: A court order to stop one party from doing some act that may harm the

other party or a child.

Service: Giving court papers to the other party. The law explains how to serve properly.

3108EN | May 2019


Temporary Family Law Order: An order entered after a case starts and before it is final. It

is only in effect while the case is going on. Temporary family law orders can end at a fixed

time, even before the case ends.

Time to Respond (or deadline to respond): The length of time you have to respond to

something filed by the other party. Example: you have 20 to 90 days after service to

respond to a Summons and Petition, depending upon the type and location of service. The

length of time to respond to motions is usually much shorter.

Working Papers: A copy of papers you file with the court and deliver before the hearing for

the judge to review. Local rules vary about whether working papers are required or, if they

are, when and where you must deliver them. Some counties require you to deliver working

papers at or near the time you file a motion or response.

Part 12. Blank Forms

The rest of this packet has blank forms for your use. Make a copy of each form so that you

have an extra in case your first draft needs lots of changes. You may need forms from other

packets. You may not need all the forms in this packet.

The Washington Administrative Office of the Courts also has Microsoft Word and PDF

versions of many of these forms available on their web site at www.courts.wa.gov/forms.

http://www.courts.wa.gov/forms

RCW 26.09.160 Mandatory Form (05/2016) FL All Family 165

Motion for Contempt Hearing

p. 1 of 4


In re:

Petitioner/s (person/s who started this case):

And Respondent/s (other party/parties):

No.


(MTSC)


To both parties:

Deadline! Your papers must be filed and served by the deadline in your county’s Local Court Rules, or by the State Court Rules if there is no local rule. Court Rules and forms are online at www.courts.wa.gov.

If you want the court to consider your side, you must: File your original documents with the Superior Court Clerk; AND Give the Judge/Commissioner a copy of your papers (if required by your county’s Local Court Rules); AND Have a copy of your papers served on all other parties or their lawyers; AND

Go to the hearing.

The court may not allow you to testify at the motion hearing. Read your county’s Local Court Rules, if any.

Bring proposed orders to the hearing.

To the person filing this motion:

To schedule a hearing on this motion, you must ask the court to sign the Order to Go to Court for Contempt Hearing (Order to Show Cause) (FL All Family 166). This Order may be signed “ex parte” (without the other party there). Contact the Superior Court Clerk’s office for the procedure in your county. You must have this Motion and the Order to Go to Court personally served (by someone else) on the other party.

To the person receiving this motion:

If you do not agree with the requests in this motion, file a statement (using form FL All Family 135, Declaration) explaining why the court should not approve those requests. You may file other written proof supporting your side.

http://www.courts.wa.gov/



p. 2 of 4

I declare:

1. I am a (check one): Petitioner Respondent in this case.

2. The other party, (name): ,did not obey

the orders checked below that were signed by the court on (date): in (county and state): :

The child support order including (check all that apply):

pay (amount) $ per month.

provide health insurance for the children and pay health care costs not covered by insurance.

pay for the children’s day care, education, long-distance transportation, and other expenses.

Describe how the order was not obeyed, including dates and amounts:

The spousal support (maintenance/alimony) order to pay (amount) $ per month.

Describe how the order was not obeyed, including dates and amounts:

The parenting plan, residential schedule or custody order.

Describe how the order was not obeyed including dates and times:

The restraining order.

Describe how the order was not obeyed including dates and times:



p. 3 of 4

Other order (specify):

Describe how the order was not obeyed including dates, times, and amounts, if any:

3. Request – I ask the court to:

Order the other party to go to court to show why the court should not approve the judgment and orders I’ve requested,

Find the other party in contempt, and

Approve the requests checked below.

4. Money judgment requested

No request.

I ask the court to approve a judgment ordering the other party to pay (check all that apply):

Amount Interest From (date) To (date)

Past due child support $ $

Past due medical support (health insurance & health care costs not covered by insurance)

$ $

Past due children’s expenses for: day care

education

long-distance transp.

other

$ $

Past due spousal support $ $

Other (specify):

$ $

5. Fines and penalties (remedial sanctions) requested

Does not apply.

Approve other reasonable orders, including ordering the other party to:

Pay a fine – civil penalty (required for violations of parenting time orders),

Pay a fine for each day the court’s orders are not followed,

Meet certain conditions to stop being in contempt (purge the contempt),

Pay my lawyer fees and costs, if any,

Give me make-up parenting time, if appropriate, and



p. 4 of 4

Any other relief allowed by law (Chapter 7.21 RCW, Chapter 26.09 RCW, Chapter 26.10 RCW, Chapter 26.26 RCW, and RCW 26.18.040).

Send the other party to jail.

6. Other orders requested (if any):

Person making this motion fills out below:

I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form are true.

Signed at (city and state): Date:

Person making this motion signs here Print name here

I agree to accept legal papers for this case at (check one):

my lawyer’s address, listed below.

the following address (this does not have to be your home address):

street address or PO box city state zip

(Optional) email:

(If this address changes before the case ends, you must notify all parties and the court clerk in writing. You may use the Notice of Address Change form (FL All Family 120). You must also update your Confidential Information Form (FL All Family 001) if this case involves parentage or child support.)

Lawyer (if any) fills out below:

Lawyer signs here Print name and WSBA No. Date

Lawyer’s street address or PO box city state zip

Email (if applicable):

Warning! Documents filed with the court are available for anyone to see unless they are sealed. Financial, medical, and confidential reports, as described in General Rule 22, must be sealed so they can only be seen by the court, the other party, and the lawyers in your case. Seal those documents by filing them separately, using a Sealed cover sheet (form FL All Family 011, 012, or 013). You may ask for an order to seal other documents.


Order to Go to Court for Contempt Hearing

p. 1 of 2


In re:



No.

Order to Go to Court for Contempt Hearing (Order to Show Cause)

(ORTSC)

Clerk’s action required: 2


(Order to Show Cause)

1. Findings

The court has reviewed the Motion for Contempt Hearing filed by the (check one): Petitioner Respondent and finds there is reason to approve this order.

2. The court orders (name): to:

Go to court on: at a.m. p.m. date time

at: in court’s address room or department

docket/calendar or judge/commissioner’s name

At the hearing, you must show why the court should not approve the requests made by the other party and find you in contempt.

Warning! If you do not go to the hearing, the court may:

Approve the other party’s requests without hearing your side, and

Issue a warrant for your arrest.

If the other party has asked the court to send you to jail, and you cannot afford a lawyer, you may ask the court to appoint a lawyer to represent you.



p. 2 of 2

3. Other orders (if any):

Ordered.

Date Judge or Commissioner

Presented by: Petitioner Respondent

Sign here Print name (if lawyer, also list WSBA #) Date

RCW 26.09.160, 7.21.010 Mandatory Form (05/2016) FL All Family 167

Contempt Hearing Order

p. 1 of 7


In re:



No.


(ORCN)

Clerk’s action required: 1, 8, 12


1. Money Judgment Summary

No money judgment is ordered.

Summarize any money judgment from section 8 in the table below.

Judgment for Debtor’s name (person who must pay money)

Creditor’s name (person who must be paid)

Amount Interest

Past due child support from to

$ $

Past due medical support from to

$ $

Past due children’s expenses from to

$ $

Past due spousal support from to

$ $

Civil penalty $ $

Lawyer fees and costs $ $

Other: $ $

Yearly Interest Rate for child support, medical support, and children’s expenses: 12% . For other judgments: ____% (12% unless otherwise listed)

Lawyer (name): represents (name):

Lawyer (name): represents (name):



p. 2 of 7

2. The court has considered the Motion for Contempt Hearing and any supporting documents, response from the other party, reply, and other documents from the court record identified by the court. A contempt hearing was held on (date): .

The Court Finds:

3. Support Payments (child support, medical support, children’s expenses, spousal support)

Does not apply. This contempt hearing did not cover support issues.

Support orders were obeyed. No support payments are past due.

Support orders were not obeyed. (Name): did not obey the following order(s) signed by the court on (date): (check all that apply):

the child support order to (check all parts of the order that were not obeyed):

pay the monthly child support payment.

provide or pay for medical support for the children (health insurance or health care costs not covered by insurance).

pay for the children’s day care, education, transportation, and other expenses.

the spousal support (maintenance) order.

This person did not pay the other party support payments required by court order in the

amounts and for the dates described in the Money Judgment in section 8 below.

a. Ability to follow orders in the past – This person (check one):

was able to follow the order/s checked above. The failure to follow the order/s was intentional.

was not able to follow the order/s checked above. The failure to follow the order/s was not intentional.

Explain:

b. Ability to follow orders now – This person

(check one): is is not able to follow the orders now.

(check one): is is not willing to follow the orders.

Explain:

Other findings:



p. 3 of 7

4. Parenting Plan, Residential Schedule, or Custody Order

Does not apply. This contempt hearing did not cover parenting/custody issues.

The parenting/custody order was obeyed.

The parenting/custody order was not obeyed. (Name): did not obey the following parts of the parenting/custody order signed by the court on (date): (check all that apply):

Parenting Time Schedule (residential provisions).

Decision-Making

Dispute Resolution (Mediation, Counseling, or Arbitration requirement for disagreements)

Other parts of the parenting/custody orders

The parenting/custody order was not obeyed as follows (check one):

As described in the Motion for Contempt Hearing.

(Describe how the order was not obeyed, including dates and times):

a. Ability to follow orders in the past – This person (check one):

was able to follow the parenting/custody order. The failure to follow the order was intentional.

was not able to follow the parenting/custody order. The failure to follow the order was not intentional.

Explain:

b. Bad faith – When this person did not obey the parenting/custody order, s/he:

(check one): acted in bad faith. did not act in bad faith.

Explain:

c. Ability to follow orders now – This person

(check one): is is not able to follow the parenting/custody order now.

(check one): is is not willing to follow the parenting/custody order.

Explain:



p. 4 of 7

Other findings:

5. Restraining Order or Other Order

Does not apply. This contempt hearing did not cover any restraining order or other orders.

The (check all that apply): restraining order other order (specify): was obeyed.

(Name): did not obey the following order signed by the court on (date):

(specify order): .

This order was not obeyed as follows (check one):

As described in the Motion for Contempt Hearing.

(Describe how the order was not obeyed, including dates and times):

a. Ability to follow order in the past – This person (check one):

was able to follow this order. The failure to follow this order was intentional.

was not able to follow this order. The failure to follow this order was not intentional.

Explain:

b. Ability to follow orders now – This person

(check one): is is not able to follow this order now.

(check one): is is not willing to follow this order.

Explain:

Other findings:

6. Lawyer fees and costs

Does not apply.

The lawyer fees and costs listed in the Money Judgment in section 8 below were

incurred and are reasonable.

Other findings:



p. 5 of 7

The Court Orders:

7. Contempt

(Name):

(check one): is in contempt. is not in contempt.

8. Money Judgment

Does not apply. No money judgment is ordered.

The court orders the following money judgment (summarized in section 1 above):

Judgment for Debtor’s name (person who must pay money)

Creditor’s name (person who must be paid)

Amount Interest

Past due child support from to

$ $

Past due medical support (health insurance & health care costs not covered by ins.) from to

$ $

Past due children’s expenses for: day care

education

long-distance transp.

other

from to

$ $

Past due spousal support from to

$ $

Civil penalty (At least $100 for 1st violation of a parenting/ custody order; at least $250 for 2nd violation within 3 years.)

$ $

Lawyer fees and costs $ $

Other (specify):

$ $

The interest rate for child support, medical support, and children’s expenses is 12%. The interest rate for other judgments is 12% unless another amount is listed below.

The Interest rate for other judgments is % because (explain):

Other:



p. 6 of 7

9. Make-up parenting time

Does not apply.

(Name): will have make-up parenting time as follows (specify dates and times):

10. Jail time

Does not apply.

(Name): must serve (number): days in the (name of county): County Jail.

Jail time is suspended (postponed) under these conditions:

The court will review compliance with these conditions at the review hearing set in

section 12 below.

Jail time starts (check one): immediately on (date): . S/He must report to the jail on this date. The detainee must be released from jail

as soon as s/he satisfies the conditions listed in section 11 below.

11. Contempt can be corrected (purged) if:

Does not apply.

(Name): does the following (specify):

12. Court review

Does not apply.

The court will review this case on (date): at (time): a.m. p.m.

in (Court, Room/Dept.):

(If you check this box, also check the “Clerk’s action required” box on page 1.)



p. 7 of 7

13. Other orders (if any)

Ordered.

Date Judge or Commissioner

Petitioner and Respondent or their lawyers fill out below.

This document (check any that apply): This document (check any that apply): is an agreement of the parties is an agreement of the parties is presented by me is presented by me may be signed by the court without notice to me may be signed by the court without notice to me

Petitioner signs here or lawyer signs here + WSBA # Respondent signs here or lawyer signs here + WSBA #

Print Name Date Print Name Date

Mandatory Form (05/2016) FL All Family 118

Notice of Appearance (for a party without a lawyer)

p. 1 of 1


In re:



No.

Notice of Appearance (for a party without a lawyer)

(APPS)

Notice of Appearance

(for a party without a lawyer)

1. My name is: .

2. I am filing this notice to appear in this case. I must be notified of any court hearings and

receive copies of any papers filed in this case.

3. I agree to accept legal papers for this case at the following address

(this does not have to be your home address):

street address or PO box city state zip

4. (Optional) I also agree to accept legal papers for this case at the following email address:

.

Sign here Date

If this address changes before the case ends, you must notify all parties and the court clerk in writing. You may use the form Notice of Address Change (FL All Family 120). You must also update your Confidential Information form (FL All Family 001) if this case involves parentage or child support.

CR 4(g), RCW 4.28.080(15) Optional Form (05/2016) FL All Family 101

Proof of Personal Service p. 1 of 3


In re:



No.

Proof of Personal Service

(AFSR)

Proof of Personal Service

Server declares:

1. My name is: . I am not a party to this case.

I am 18 or older.

2. Personal Service

I served court documents for this case to (name of party): by (check one):

giving the documents directly to him/her.

giving the documents to (name): , a person of suitable age and discretion who lives at the same address as the party.

3. Date, time, and address of service

Date: Time: a.m. p.m.

Address:

Number and street city state zip



4. List all documents you served (check all that apply): (The most common documents are listed below. Check only those documents that were served. Use the “Other” boxes to write in the title of each document you served that is not already listed.)

Petition to/for

Summons (Attach a copy.) Notice of Hearing

Order Setting Case Schedule Motion for Temporary Family Law Order

and Restraining Order

Notice Re Military Dependent Proposed Temporary Family Law Order

Proposed Parenting Plan Motion for Immediate Restraining Order (Ex Parte)

Proposed Child Support Order Immediate Restraining Order (Ex Parte) and Hearing Notice

Proposed Child Support Worksheets Restraining Order

Sealed Financial Documents Motion for Contempt Hearing

Financial Declaration Order to Go to Court for Contempt Hearing

Declaration of:

Notice of Intent to Move with Children (Relocation)

Declaration of:

Objection about Moving with Children and Petition about Changing a Parenting/ Custody Order (Relocation)

Other:

Other:

Other:

Other:

5. Fees charged for service

Does not apply.

Fees: $ _______ + Mileage $ _______ = Total: $________

6. Other Information (if any):

I declare under penalty of perjury under the laws of the state of Washington that the statements on this form are true.


Signature of server Print or type name of server

To the party having these documents served:

File the original Proof of Personal Service with the court clerk.

If you served a Restraining Order signed by the court, you must also give a copy of this Proof of Personal Service and a Law Enforcement Information Sheet to law enforcement.



To the Server: check here if you personally served the documents outside Washington state. Your signature must be notarized or sworn before a court clerk.

(For personal service in Washington state, your signature does not need to be notarized or sworn before a court clerk.)

Signed and sworn to before me on (date): .

Signature of notary or court clerk

Print name of notary or court clerk

I am a notary public in and for the state of:

My commission expires:

I am a court clerk in a court of record in

(county):

(Print seal above.) (state):

Optional Form (05/2016) FL All Family 135

Declaration p. 1 of __


In re:



No.

Declaration of (name):

(DCLR)

Declaration of (name):

1. I am (age): years old and I am the (check one): Petitioner Respondent

Other (relationship to the people in this case):

2. I declare:

Optional Form (05/2016) FL All Family 135

Declaration p. 2 of __

(Number any pages you attach to this Declaration. Page limits may apply.)

I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form (and any attachments) are true. I have attached (number): pages.


Sign here Print name

Warning! Documents filed with the court are available for anyone to see unless they are sealed. Financial, medical, and confidential reports, as described in General Rule 22, must be sealed so they can only be seen by the court, the other party, and the lawyers in your case. Seal those documents by filing them separately, using a Sealed cover sheet (form FL All Family 011, 012, or 013). You may ask for an order to seal other documents

RCW 26.23.050; 26.50.160; GR 22 Mandatory Form (05/2016) FL All Family 001

Confidential Information

p. 1 of 2

Confidential Information (CIF) Clerk: Do not file in a public access file Superior Court of Washington, County:

Case No.:

Important! Only court staff and some state agencies may see this form. The other party and his/her lawyer may not see this form unless a court order allows it. State agencies may disclose the information in this form according to their own rules.

1. Who is completing this form? (Name):

2. Is there a current restraining or protection order involving the parties or children? Yes No

If Yes, who does the order protect? (Name/s):

3. Does your address information need to be confidential to protect your or your children’s health, safety, or liberty? (Check one): Yes No

If Yes, explain why?

4. Your Information

Full name (first, middle, last):

Date of birth (MM/DD/YYYY):

Sex: M F

Driver’s license/Identicard (#, state):

Race:

Relationship to children in this case:

Mailing address (This address will not be kept private.) (street address or PO box, city, state zip):

If your case is only about a protection order, the information below is not required. Skip to 5.

Home address (check one): same as mailing address listed below (street, city, state, zip):

Phone: Email: Social Sec. #:

Employer’s name: Employer’s phone:

Employer’s address:

5. Other Party’s Information – This person is a (check one): Petitioner Respondent



Sex:

M F


Race:







RCW 26.23.050; 26.50.160; GR 22 Mandatory Form (05/2016) FL All Family 001

Confidential Information

p. 2 of 2


Skip sections 6 – 9 if your case does not involve children. Sign at the end.

6. Children’s Information (You do not have to fill out the children’s Social Security numbers if your

case is only about a protection order.)

Child’s full name (first, middle, last)

Date of birth (MM/DD/YYYY)

Race Sex Soc. Sec. # Current location: lives with

1. M F

Petitioner Respondent other:

2. M F


3. M F


4. M F


5. M F


6. M F


7. Have the children lived with anyone other than Petitioner or Respondent during the last five years? (Check one): No Yes If Yes, fill out below:

Children lived with (name) That person’s current address

1.

2.

8. Do other people (not parents) have custody or visitation rights to the children? (Check one): No Yes If Yes, fill out below:

Person with rights (name) That person’s current address

1.

2.

9. If you are asking for custody and are not the parent, list all other adults living in your home:

1. (Name): Date of birth (MM/DD/YYYY):

2. (Name): Date of birth (MM/DD/YYYY):

I declare under penalty of perjury under Washington State law that the information on this form about me is true. The information about the other party is the best information I have or is unavailable because (explain):

Check here if you need more space to list other Petitioners, Respondents, or children. Put that information

on the Attachment to Confidential Information, form FL All Family 002, and attach it to this form.


Petitioner/Respondent signs here Print name here


Attachment to Confidential Information (Additional Parties or Children)

p. 1 of 1

Attachment to Confidential Information (Additional Parties or Children) (AT)

Clerk: Do not file in a public access file

County:

Case No.:

Use this form if there are more parties or children in your case than you can list on the Confidential Information form.

1. Other Party’s Information (if any) – This person is a (check one): Petitioner Respondent



Sex: M F


Race:








2. Other Party’s Information (if any) – This person is a (check one): Petitioner Respondent



Sex: M F


Race:








3. Other Children’s Information (if any) (You do not have to fill out the children’s Social Security

numbers if your case is only about a protection order.)

Child’s full name (first, middle, last)

Date of birth (MM/DD/YYYY)

Race Sex Soc. Sec. #

Current location: lives with

7. M F


8. M F


GR 22(b)(3), (g) Mandatory Form (05/2016) FL All Family 012

Sealed Personal Health Care Records

p. 1 of __


In re:



No.

Sealed Personal Health Care Records (Cover Sheet)

(SEALPHC)

Clerk’s action required.

For use in Family Law and Guardianship cases.

Sealed Personal Health Care Records

(Cover Sheet)

Use this form as a cover sheet to keep your personal health information private from the public. On the first page of each document, write the word “SEALED” 1 inch from the top of the page.

Check the documents you are attaching to this cover sheet to be sealed:

Health records of any kind (including correspondence) related to a person’s physical or mental condition, or payment for health care.

Genetic test records for parentage.

Submitted by: Petitioner or his/her lawyer Respondent or his/her lawyer

Sign here Print name (if lawyer, also provide WSBA #)

Important! The other person and the lawyers in your case can see your sealed documents. If you need to keep your address information private for safety reasons, you may cross out or delete your address information.

GR 22(e), (g) Mandatory Form (05/2016) FL All Family 013

Sealed Confidential Report

p. 1 of __


In re:



No.

Sealed Confidential Report (Cover Sheet)

(SEALRPT)



Sealed Confidential Report (Cover Sheet)

Use this form as a cover sheet to keep any confidential part of a report private from the public. On the first page of each document, write the word “SEALED” 1 inch from the top of the page.

Check the reports you are attaching to this cover sheet to be sealed. Only the following parts of these reports are confidential and should be attached:

Detailed descriptions of material, or information gathered or reviewed; Detailed descriptions of all statements reviewed or taken; Detailed descriptions of tests conducted or reviewed; or Analysis to support the conclusions and recommendations.

(A public version of the report without the confidential parts may be filed separately.)

Parenting evaluations

Domestic Violence Assessment Reports (from Family Court Services or a court-appointed expert)

Risk Assessment Reports (from Family Court Services or an expert)

CPS Summary Reports (from Family Court Services or directly from CPS)

Sexual abuse evaluations

Report from a Guardian ad Litem (GAL) or Court Appointed Special Advocate (CASA)

Other (specify):

Submitted by: Petitioner or lawyer Respondent or lawyer Other:



GR 22(b)(8), (g) Mandatory Form (05/2016) FL All Family 011

Sealed Financial Source Documents

p. 1 of __


In re:



No.

Sealed Financial Source Documents (Cover Sheet)

(SEALFN)



Sealed Financial Source Documents

(Cover Sheet)

Use this form as a cover sheet to keep your financial documents private from the public. On the first page of each document, write the word “SEALED” 1 inch from the top of the page.

Check the documents you are attaching to this cover sheet to be sealed:

Income tax records Pay stubs or other proof of earnings

Credit card statements Bank statements

Checks or the equivalent Loan application documents

Check registers Retirement plan orders

Other financial information sealed by court order (specify):

Submitted by: Petitioner or his/her lawyer Respondent or his/her lawyer



EVALUATION FORM – How was this 3108EN FILING A MOTION FOR CONTEMPT packet? Your comments are appreciated and will help to make this packet more useful to others. Please

take a moment to complete this form and return it to:

LeeAnn Friedman Northwest Justice Project

500 W. 8th, Suite 275 Vancouver, WA 98660

Or email to [email protected] 1. Where did you get this packet?

CLEAR washingtonlawhelp.org Court Clerk or Facilitator

Other:

2. What is your primary language?

3. Are you low-income? yes no

4. What is the last grade you finished in school?

5. Did you read the instructions? yes no

6. Did you need the help of an agency, court facilitator, or advocate to complete your case?

yes no

If yes, what agency or individual helped you?

7. Did you find anything hard to understand? yes no

If yes, please tell us what.

8. Did you find any mistakes? yes no

Describe mistakes. Include the page #.

9. Additional Comments [use back if you need to]:

10. Today’s Date:

mailto:[email protected]
