COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. Revised 12/04/03 : Calendar No. UNITED STATES BANKRUPTCY COURT : MIDDLE DISTRICT OF LOUISIANA JUDICIAL SUBPOENA Plaintiff(s) -against- IN RE : CASE NO. : DECLARATION UPON ELECTRONIC FILING OF BANKRUPTCY CASE : Defendant(s) : (Check the applicable documents) ...................................................... [ ] Petition, Schedules & Statements, and Accompanying Declarations; Amendments [ ] Mailing Matrix Verification; Amendment to Mailing Matrix Verification [ ] Affidavit in Support of Employment of Attorney or Other Professional [ ] PEOPLE OF THE STATE OF NEW YORK THE Affidavit in Support of or in Opposition to Motion For Summary Judgment [ ] Verification Supporting Extension of deadline to File Statements, Schedules, Chapter 13 Plan [ TO ] Verification of chapter 11 Monthly Reports [ ] Other:(please describe)____________________________________________________ PART I – DECLARATION O F PETITIONER I[We], ___ _____ _____ _____ _____ _____ _____ _____ _____ _, the undersigned debtor(s), or representative of the GREETINGS: Debtor(s) hereby declare under penalty of perjury as follows: WE COMMAND reviewed the all business contained in the documents designatedand each of you attend before (1)(a) I [We] have YOU, that information and excuses being laid aside, you (above, by check , the Honorable Declaration to have been electronically filed in the captioned bankruptcy case (the Documents); or at the Court marks) in this located at County of is a corporation or Partnership) that I [we] am [are] authorizednoon, andand any recessed to act for at on in room (1)(b) (Only if the Debtorday of , on the , 20 , at o'clock in the orbehalf of the date, to testify and give evidence as a and the Documents designated in thisof the adjourned debtor both in executing this Declaration witness in this action on the part Declaration to have been electronically filed (the Documents); (2) I [We] have provided my [our] social security number(s) that is [are] correct and true; Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to (3) I [We] have authorized the electronic filing for a maximum penalty attorney, or, all damages sustained as a the party on whose behalf this subpoena was issued of these Documents by our of $50 and if applicable, we have of your failure to comply.own behalf; filed the D ocuments on our result (4) My [Our] attorney shall retain the originally signed Documents subject to the Rules of the Bankruptcy one of the Justices of closed; Court forWitness,of one year after the case or proceeding in which the Documents ,have been filed has been the a period Honorable Court in County, day of , 20 (5) I [W e] und erstand that this Declaration shall be ma intained by the C lerk of the Bankrup tcy Co urt; (6) I [We] affirmatively state that my [our] electronic signature(s) contained on the Documents is [are] my (Attorney must sign of the bankruptcy below) [our] signatures for purposes of the filing of the Documents on the record of the docket above and type namecase, and for all purposes authorized by law, and that My/our electronic signatures on the Documents is/are a Declaration, Certification, Verification or Statement to the same extent and shall have the same effect as our signatures on the original Do cuments; Attorney(s) for (7) [If represe nted b y counsel] I [W e] have signed the Documents and this Declaratio n after discussion with our attorney, before the Documents were electronically filed. DATED: Office and P.O. Address Signed: Debtor SSN: (Debtor) Signed: _______________________________ (Joint Debtor) Signed: _______________________________ (Debtor Representative) Joint Telephone No.: Debtor SSN: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. Revised 12/04/03 : Index No. PART II–DECLARATION OF AFFIANT OTHER THAN PETITIONER I[We], ____________________________________________, the undersigned Affiant(s) hereby : Calendar No. declare under penalty of perjury as follows: : JUDICIAL SUBPOENA Plaintiff(s) (1) I[We] have reviewed the information contained in the documents designated (above, by check marks) -against: in this Declaration to have been electronically filed in the captioned bankruptcy case or proceeding (the Documents); : (2) I[We] have authorized the electronic filing of these Documents by the undersigned attorney, Trustee, : Committee, or Party; Defendant(s) : . .(3) .the .undersigned.attorney, . . . . . . . . . . . . . . . . . or . . . . . .shall.retain the originally signed Documents, . . . . . . . . . . . . . . . . . . . . Trustee, Committee, . . Party; . . . subject to the Rules of the Bankruptcy Court, for a period of one year after the case or proceeding in which the Documents have been filed has been closed; (4) PEOPLE OF THE STATE OF NEW YORK THE I[We] understand that this Declaration shall be maintained by the Clerk of the Bankruptcy Court; (5) TO I[We] affirmatively state that my[our] electronic signature[s] contained on the Documents is[are] my[our] signatures for purposes of the filing of the Documents on the record of the docket of the bankruptcy case, and for all purposes authorized by law, and that My/our electronic signatures on the Documents is/are a Declaration, Certification, Verification or Statement to the same extent and shall have the same effect GREETINGS: as our signatures on the original Documents. DATED: COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before WE , the Honorable at the Court located at County of inSigned: ____________________________________ room , on the day of , 20 , at o'clock in the noon, and at any recessed (Affiant) or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply OF this subpoena PART III – DECLARATIONwith ATTORNEY 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. of perjury as follows: I declare under penalty Witness, Honorable , one of the Justices of the (1) I have reviewed the Documents designated (above, by check marks) in this Declaration as having been filed on behalf County, of the named debtors[s] or (if applicable) the affiant (the Documents); Court in day of , 20 (2) the debtor[s] or representative of the debtor[s] or the affiant signed this Declaration after review of the originally signed Documents before I filed the Documents electronically on the docket of the record (Attorney must sign above and type name below) of this case or proceeding; (3) I acknowledge and accept the responsibility to maintain the original signed Documents under my care Attorney(s) for custody and control, subject to the rules of this Bankruptcy Court, for a period of one year after the case or proceeding in which the Documents were filed has been closed. DATED: Office and P.O. Address Attorney for Debtor(s) or Attorney for Affiant or Attorney for Party submitting Affidavit or Telephone No.: Trustee Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com