COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : Plaintiff(s) -against: Index No. Calendar No. JUVENILE COURT JUDICIAL SUBPOENA NEVADA COUNTY : : In re: CASE NO. : Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .a .Minor,. . . . . . . . . . . . . ..... DECLARATION RE NOTICE OF EX PARTE APPLICATION D.O.B.: THE PEOPLE OF THE STATE OF NEW YORK TO I, _______________________________________, declare: 1. I am counsel social worker mother father minor Department of Social Services or other (explain) ____________________________ in this dependency action. GREETINGS: 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 2. Pursuant to Juvenile Court Local Rules, I have given notice of, and a copy of the WE COMMAND YOU, that all business and excuses persons and you and each of specified, and application for ex parte orders to, the following being laid aside,in the manner you attend before , the Honorable received the response noted (Attachat the additional pageCourt as needed): located at County of ________________________________________________________________________ ________________________________________________________________________ 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 reasons(s): Court in County, ________________________________________________________________________ 3. I have not given notice of this application for ex ,parte orders for the following one of the Justices of the a. Would frustrate the purpose of the orders requested. b. Minor would suffer immediate and irreparable harm before the orders could day of , 20 issue. (Attorney c. I made reasonable, good faith efforts to must sign above and type name below) give notice, as follows: __________________________________________________________________ Attorney(s) for d. Other:_______________________________________________________ I declare under penalty of perjury under the laws of the State of California the foregoing is true and correct. Office and P.O. Address Executed on _____________________ at _________am/pm, at _______________, California. Telephone No.: ____________________________________ Facsimile No.: Signature of E-Mail Address: Declarant __________________________________________________________________________________________________________________________________________________________________ DECLARATION RE NOTICE OF EX PARTE APPLICATION LOCAL JV6 (Effective 7/1/03) Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com