COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Plaintiff(s) -against: Index No. Calendar No. JUDICIAL SUBPOENA : UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA : CASE NUMBER : Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PLAINTIFF(S). . . . . . . . . ......... v. NOTICE AND ACKNOWLEDGMENT OF RECEIPT OF SUMMONS AND COMPLAINT DEFENDANT(S). THE PEOPLE OF THE STATE OF NEW YORK (For use with State Service only) To: TO The summons and complaint served herewith are being served pursuant to Rule 4(e)(1) of the Federal Rules of Civil Procedure and Section 415.30 of the California Code of Civil Procedure. GREETINGS: You may complete the acknowledgment part of this form and return the completed form to the sender within twenty (20) days. 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 are served on behalf of a corporation, unincorporated association including a partnership, or other entity, you If you of must indicate under your signature your of in room , on the day relationship to that entity and your authorization to receiveand at any recessed , 20 , at o'clock in the noon, process for that or adjourned date, to on behalf give evidence as and you in authorized to the part of the entity. If you are servedtestify and of another person a witnessare this action on receive process, you must indicate your authority under your signature. IF YOU DO NOT complete and return the form to the sender within twenty (20) days, you (or the party on whose Your failure to comply with this to pay any punishable as a contempt of a summons and complaint in any behalf you are being served), may be requiredsubpoena is expenses incurred in serving court and will make you liable to themanner permittedbehalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a party on whose by law. other result of your failure to comply. IF YOU DO complete and return this form, you (or the party on whose behalf you are being served), must answer the Witness, Honorable , one of the Justices of the complaint within the time provided in Rule 12 of the Federal Rules of Civil Procedure or judgment by default may be Court in day the taken against you for the County, relief demanded inof complaint., 20 I declare, under penalty of perjury, that this Notice and Acknowledgment of Receipt of Summons and Complaint was mailed on . (Attorney must sign above and type name below) Signature of Sender Attorney(s) for ACKNOWLEDGMENT OF RECEIPT OF SUMMONS AND COMPLAINT (To be completed by recipient) I declare under penalty of perjury, that I received a copy of the summons and complaint in the above-captioned matter at Office and P.O. Address on Address Date Telephone No.: Signature Facsimile No.: E-Mail Address:Entity/Authority to Receive Service of Process Relationship to Mobile Tel. No.: CV-21 (02/04) NOTICE AND ACKNOWLEDGMENT OF RECEIPT OF SUMMONS AND COMPLAINT American LegalNet, Inc. www.USCourtForms.com