IN THE JUDICIAL DISTRICT DISTRICT COURT OF COUNTY, KANSAS ) Plaintiff ) v. ) Case No. ) Defendant ) 60-245a: DECLARATION OF CUSTODIAN OF BUSINESS RECORDS (1) I am a duly authorized custodian of the business records of and have the authority to certify those records. (2) The copies of the records attached to this declaration, if any, are attached pursuant to subsection insert (i), (ii) or (iii) below. Complete one of the following: (i) The copies of the records attached to this declaration are all of the records described in the subpoena dated , 20 . or (ii) The copies of the records attached to this declaration are part of the records described in the subpoena dated , 20 . The following requested records are not in the business222s possession, custody, or control: . or (iii) No records are attached to this declaration because none of the records described in the subpoena dated , 20 are in the business222s possession, custody, or control. American LegalNet, Inc. www.FormsWorkFlow.com (3) The records, if any, were prepared by the personnel or staff of the business, or persons acting under their control, in the regular course of the business at or about the time of the act, condition, or event recorded. I declare under penalty of perjury that the foregoing is true and correct. Executed on: , 20 (Signature of Custodian) Name Address Telephone [Facsimile number] [Email address] CERTIFICATE OF SERVICE I certify that a copy of the above Declaration of Custodian of Business Records was served on (attorney222s name) on the day of , 20 , as follows: . (Signature) YOU MUST FILE WITH THE COURT THE ORIGINAL DECLARATION ONLY. DO NOT SEND COPIES OF THE RECORDS TO THE COURT. American LegalNet, Inc. www.FormsWorkFlow.com