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 TOGUARDIANSHIP OF: NO: GREETINGS: STATEMENT OF PARENT WAIVING PRESENTATION OF ORDER OF GUARDIANSHIP (WV) D.O.B.: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before I. STATEMENT , the Honorable at the Court located at County of q mother Petition has in1.1 room I am the , on the q father of the minor child for ,whose benefit a Guardianshipnoon, and at any recessed day of , 20 at o'clock in the been filed. or adjourned date, to testify and give evidence as a witness in this action on the part of the 1.2 I realize that a petition for guardianship has been filed, and that ____________________ ____________________________________________ (Name(s)) is (are) the proposed guardian(s). 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 1.3 I have read the petition result of your failure to comply. for guardianship and understand its contents. 1.4 I realize that if the guardianship is established, the Juvenile Court will determine the frequency of Witness, between myself and my child and the need for the continued involvement of a the , one of the Justices of visitation Honorable Court in supervising agency. County, day of , 20 1.5 I agree that ____________________________________________________________ _______________________ (Name(s)) may be appointed guardian without further notice to me. However, I do recognize that I have the(Attorney must the court andchange the right to ask sign above to type name below) guardianship once it is established. Dated: ______________________ ____________________________________________ Attorney(s) for Signature Office and P.O. Address STATEMENT OF PARENT (WV) - Page 1 of 2 WPF JU 03.0720 (9/2000) - RCW 13.34.232 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : II.Plaintiff(s) CERTIFICATION Calendar No. : JUDICIAL SUBPOENA -against: I certify under penalty of perjury under the laws of the state of Washington that the foregoing statement is true and correct. : Dated at _____________________________ (Place), Washington on __________________ (Date) : _____________________________________________ Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Signature . . . . . . . . . . . . ........ _____________________________________________ Type or Print Name THE PEOPLE OF THE STATE OF NEW YORK TO _____________________________________________ Address _____________________________________________ GREETINGS: _____________________________________________ Telephone 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 STATEMENT OF PARENT (WV) - Page 2 of 2 WPF JU 03.0720 (9/2000) - RCW 13.34.232 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com