COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index UNITED STATES DISTRICT COURT No. MIDDLE DISTRICT OF FLORIDA : Calendar No. SPECIAL ADMISSION : Plaintiff(s) ATTORNEY CERTIFICATIONJUDICIAL SUBPOENA -against- : This attorney certification form and the information contained herein neither replaces nor supplements the filing and service of pleadings, motions, or other papers as required by law, rule, or court order. This form is required for use by the Clerk of Court in furtherance of the Guidelines and Plan Administration:of Non-Appropriated Funds as adopted by this Court and this form will not be handled as a pleading, motion, or other paper filed in a case before the Court. : Defendant(s) : ...................................................... Plaintiff(s)/Petitioner(s), v. THE PEOPLE OF THE STATE OF NEW YORK CASE NO: TO , Defendant(s)/Respondent(s) / GREETINGS: hereby submit this attorney certification form to the Court on behalf I, WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before . of , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed orATTORNEY INFORMATION give evidence as a witness in this action on the part of the adjourned date, to testify and Firm Name: Address:Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a State: maximum penalty of $50 and all damages sustained as a City: Zip: result of your failure to comply. Firm/Business Phone: - - Witness, Firm/Business Fax: Honorable - - Court in County, day of E-mail Address: ATTORNEY CERTIFICATION - Alternate Phone: - , one of the Justices of the @ , 20 (Attorney must sign above and type name below) I certify that: 1. 2. 3. 4. To my knowledge there are NO disciplinary or suspension proceedings pending against me in any Court of the United Attorney(s) for States or of any State, Territory, or Possession of the United States. NOTE: If proceedings ARE pending at this time, please explain on the reverse side of this form. I am not a resident of the State of Florida. I do not make frequent or regular appearances in separate cases to such a degree as to constitute the maintenance of a regular practice of law in the State of Florida. Office and P.O. Address Within the twelve (12) month period preceding the date of this attorney certification, I have read the most current version of the Local Rules of the United States District Court for the Middle District of Florida. I declare under penalty of perjury that the foregoing is true and correct. Signature PHV Attorney Certification/Revised 06/24/04 Telephone No.: Facsimile No.: Date E-Mail Address: Mobile Tel. No.: Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : CASE MANAGEMENT / ELECTRONIC CASE FILING (CM/ECF) : Index No. Calendar No. To obtain a login and password necessary to participate in the Middle District of Florida’s Case Management / Electronic Case Filing (CM/ECF) system, please check our web page at www.flmd.uscourts.gov. Plaintiff(s) -against- : JUDICIAL SUBPOENA : ATTORNEY SPECIAL ADMISSION FEE : Attorneys specially admitted to practice in the Middle District of Florida under the conditions prescribed in Rule 2.02 of the Local Rules of the United States District Court for the Middle District of Florida, or Rule 2.0901(c)(1) of the Local Bankruptcy Rules for the Middle District of Florida, are required to pay to the Clerk a fee : of $10.00 per case. The special admission fee is due with this attorney certification. Payment should be in U.S. currency and checks must be drawn on aDefendant(s) U.S. bank. Please make checks payable to “Clerk, U.S. District : . .Court.” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... Providing the Court with an attorney certification form and the $10.00 Special Admission Fee, DOES NOT satisfy the requirements of Rule 2.02, Local Rules for the Middle District of Florida. THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address PHV Attorney Certification/Revised 06/24/04 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com