COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) IN THE ____________ COURT OF ____________ COUNTY, WEST VIRGINIA -against- _________________________ Plaintiff or Petitioner : : : Defendant(s) v. : ...................................................... Case No. ____________ _________________________ Defendant or Respondent THE PEOPLE OF THE STATE OF NEW YORK TO ORDER: TO FILE NEW FINANCIAL AFFIDAVIT AND APPLICATION FOR WAIVER OF FEES, COSTS, OR SECURITY GREETINGS: 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 This court hereby ORDERS ________________________________________ in room , on the day of , 20 , at o'clock party) noon, and at any recessed (name of in the or adjourned date, to testify and give evidence as a witness in this action on the part of the to file a new financial affidavit and application for determination by this court as to eligibility for comply of fees, costs, or security attendant to proceedings will services in this Your failure to waiver with this subpoena is punishable as a contempt of court and and 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. case. __________________________________________ shall not be eligible for such (name of party) Witness, Honorable , one of the Justices of the Court in waiver until a further order of this court grants his or her new application. County, day of , 20 (Attorney must sign above and type name below) ENTER, this __________ day of ______________________________. Attorney(s) for ________________________________ Circuit Judge/Family Court Judge/Magistrate Office and P.O. Address SCA-C&M204.03 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com