Verification (Respondents Contempt Verification)

IN THE SUPERIOR COURT OF FULTON COUNTY STATE OF GEORGIA FAMILY DIVISION Petitioner: ______________________________ and Respondent: _____________________________ Civil Action File No: VERIFICATION I, ________________________, personally appeared before the undersigned Notary Public, and say under oath that I am the Respondent in the above-styled action and that the facts stated in the Response to Citation of Contempt are true and correct. This the ____________________day of______________________, _____. [date] [month] [year] Pro Se Respondent's name (print or type): ________________ Respondent's address:____________________________ (Sign your name here in front of the Notary) _______________________________________________ ____________________________________________________________________________________________ Respondent's telephone number: ( ) Sworn to and subscribed before me, this _____ day of _______________ , ______. NOTARY PUBLIC My Commission Expires: (Notary Seal) Contempt ­ Respondent's Verification Form © 2006Fulton County Superior Court Family Division Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com