COMMONWEALTH OF PENNSYLVANIA COUNTY OF BUCKS : : : vs. : File No. : : : SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: at (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: ADDRESS: TELEPHONE: SUPREME COURT ID # ATTORNEY FOR: BY THE COURT: Judith J. Reiss Prothonotary Date: Seal of the Court Deputy Completed Subpoena must be signed and sealed by the Prothonotary before service (Rev 12/17) American LegalNet, Inc. www.FormsWorkFlow.com RETURN OF SERVICE: On the day of , , I, served (name of person served) with the foregoing subpoena by: (Describe method of service) I verify that the statements in this return of service are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. 247 4904 relating to unsworn falsification to authorities. DATE: (signature) C-1F-4 American LegalNet, Inc. www.FormsWorkFlow.com