Index No. SUPERIOR COURT, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA : BANNING 155 E. Hays, Banning, CA 92220 BLYTHE 265 North Broadway, Blythe, CA 92225 HEMET 880 N. State St., Hemet, CA 92543 INDIO 46-200 Oasis St., Indio, CA 92201 -against- Plaintiff(s) Calendar No. MURRIETA 30755-D Auld Road, Murrieta, CA 92563 RIVERSIDE 4050 Main St., Riverside, CA 92501 : JUDICIAL SUBPOENA RIVERSIDE 4175 Main St., Riverside, CA 92501 TEMECULA 41002 County Center Dr., #100, Temecula, CA 92591 : : SMALL CLAIMS COURT : Defendant(s) : ...................................................... ____________________________________________________ Plaintiff(s), THE VS CASE NO. PEOPLE OF THE STATE OF NEW YORK DECLARATION RE: DEFAULT IN PAYMENTS TO _______________________________________________________ Defendant(s). GREETINGS: WE COMMAND YOU, that all IN THE ABOVE-ENTITLED ACTION THE UNDERSIGNED JUDGMENT CREDITORbusiness and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of DECLARES: That judgment was entered against judgment debtor__________________________________________________________ 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 on ___________ for $______________ per ____________ commencing ____________________________________________________ That $____________________ has been paid on the judgment; that the installment due on 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 _________________________ has result of your failure to comply. not been paid. Therefore, judgment creditor requests that execution issue. Witness, Honorable Court in County, day of , one of the Justices of the , 20 Executed on __________________________, at ____________________________________, California. I declare under penalty of perjury that the foregoing is true and correct. (Attorney must sign above and type name below) Attorney(s) for JUDGMENT CREDITOR Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: SCL009 (Rev. 07/01/2003) DECLARATION - RE: Default in Payments American LegalNet, Inc. www.USCourtForms.com RISCL009