COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... SUPERIOR COURT OF WASHINGTON COUNTY OF _______________________ THE PEOPLE OF THE STATE OF NEW YORK JUVENILE COURT TO Dependency of: NO: NOTICE AND SUMMONS/ORDER (DEPENDENCY/GUARDIANSHIP/ GREETINGS: TERMINATION OF PARENT-CHILD RELATIONSHIP) WE D.O.B.: COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before (NTSM) , the Honorable at the Court located at County of inSTATE OF WASHINGTON TO: of room , on the day , 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 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 I. NOTICE for a maximum penalty of $50 and all damages sustained as a was issued OF HEARING result of your failure to comply. 1.1 You are notified that a petition, a copy of which is attached, was filed with this court alleging that: q the above-named child is dependent. A Dependency Petition begins a judicial process Witness, Honorable court finds the child dependent, could result in, substantial Justices of or one of the restriction the which, if the permanent loss of yourof Court in County, day parental rights. 20 , q guardianship should be established for the above-named child. A Guardianship Petition, if granted, could result in substantial restrictions of your parental rights. q the above-named child is dependent and a permanent termination of the parent-child (Attorney must sign above and type name below) relationship should occur. A termination petition, if granted, will result in permanent loss of your parental rights. If your child is placed in out-of-home care, you may be held responsible for the support of the child. 1.2 Attorney(s) for A fact-finding hearing has been set in this matter on _______________ (date) at _____ a.m./p.m., at: ________________________________ Court, Room/Department _________________ Address: 1.3 _______________________________________________ Office and P.O. Address _______________________________________________ The purpose of the hearing is to hear and consider evidence on the petition. You should be present at this hearing. Telephone No.: No.: E-Mail Address: Mobile Tel. No.: NT & SUMMONS/ORD (DEP/GUARD/TERM) (NTSM) - Page 1 of 2 Facsimile WPF JU 03.0200 (9/2000) - JuCR 3.4; RCW 13.34.070, .080, .180, .230 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : 1.4 Index No. Calendar No. : If you do not appear THE COURT MAY ENTER AN ORDER IN YOUR ABSENCE: JUDICIAL SUBPOENA Plaintiff(s) q q q Establishing dependency; -againstEstablishing guardianship; Permanently terminating your parental rights. : : II. SUMMONS/ORDER TO APPEAR : 2.1 q YOU ARE SUMMONED AND REQUIRED to appear at the hearing on the date, time, Defendant(s) and place indicated. : . .2.2 . . . . q . . . . .YOU. ARE . . . . . . . . . . AND REQUIRED . . .the.parent, guardian or custodian having .. .. . . . . . . . ORDERED . . . . . . . . . . . . . . as . . . custody or control of the child to bring the child to the hearing. NOTICE THE PEOPLE OF THE STATE OF NEW YORK VIOLATION OF THIS ORDER OR SUMMONS IS SUBJECT TO A PROCEEDING FOR CONTEMPT OF TO COURT PURSUANT TO RCW 13.34.070 III. ADVICE OF RIGHTS 3.1 You have important legal rights, and you must take steps to protect your interest. 3.2 You GREETINGS:have the right to a fact-finding hearing before a judge. At the hearing, you have the right to speak on your own behalf, to introduce evidence, to examine witnesses, and to receive a decision based solely on the all business and excuses being laid aside, you and each of you attend before WE COMMAND YOU, that evidence presented to the judge. You should attend this hearing. 3.3 You lawyer. If you cannot afford a lawyer you have the , the Honorable have the right to be represented by aat the Court located at County ofright to request that the court appoint a lawyer to represent you at public expense. If you qualify, in room a lawyer ,will be appointed by the court to ,representat on the day of 20 , you. o'clock in the noon, and at any recessed Your lawyer can look give social and a witness in this case, on to part of the or3.4 adjourned date, to testify andat the evidence aslegal files in your actiontalk thethe agency social worker, tell you about the law, help you understand your rights and help you at hearings. 3.5 If you wish to have a lawyer appointed, contact __________________________________ (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_______________________________________________ and all damages sustained as a this subpoena was issued for a maximum penalty of $50 Phone: _______________________________________________ result of your failure to comply. You may call Witness, Honorable agency’s name and telephone numbers are: Court in Address: Phone: County, day of (Name) for more information about your child. The , one of the Justices of the , 20 _______________________________________________ _______________________________________________ _______________________________________________sign above and type name below) (Attorney must Dated: _____________________________ By direction of: _____________________________________________ Attorney(s) for JUDGE/COMMISSIONER _____________________________________________ Clerk By:____________________________________________ Deputy Clerk Office and P.O. Address Telephone No.: No.: E-Mail Address: Mobile Tel. No.: NT & SUMMONS/ORD (DEP/GUARD/TERM) (NTSM) - Page 2 of 2 Facsimile WPF JU 03.0200 (9/2000) - JuCR 3.4; RCW 13.34.070, .080, .180, .230 American LegalNet, Inc. www.USCourtForms.com