COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. STANISLAUS COUNTY SUPERIOR COURT ______________________________ -against- ) In the Matter of: ) ) ______________________________) : Plaintiff(s) JUDICIAL SUBPOENA : Case No.:_______________ DECLARATION AND ORDER FOR ATTORNEY FEES/RECAPITULATION : “JUVENILE FEE CLAIM” : The undersigned attorney, who is duly licensed to practice law in California, declares that on _______________ the Honorable _____________________ presiding, appointed the undersigned to Defendant(s) : ‫ ٱ‬W&I . . . . . represent. .____________________. ‫.ٱ‬minor(s) .‫ ٱ‬parent ‫ .ٱ‬legal. guardian in a ‫ ٱ‬W&I Code §300 or ...... ................. ...... ..... ... ..... Code §602 proceeding on _______________, the final disposition states that he has performed the legal services and incurred the expenses listed in this Declaration as follows, and which are reasonable and necessary. Description of Time in 1/10 THE PEOPLE OF Date STATE OF NEW YORKActivity or Time Sheet No. THE 1. 2. TO 3. Total __________ X $____________ = ____________ GREETINGS: ‫ ٱ‬I have received payment of $ __________ on this case. (List YOU, that all business and on reverse side laid attachments.) WE COMMANDadditional information in order excuses being or as aside, you and each of you attend before I declare under penalty of perjury that the foregoing, including any attachments, is true and correct. , the Honorable at the Court Executed on ____________________, at Modesto, California. located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Print Name:________________________ Telephone No.:___________________________ or adjourned date, to testify and give evidence as a witness in this action on the part of the _______________________________________ _________________________________ Declarant’s Signature _______________________________________ Address ORDER Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Pursuant to the above declaration and the information provided therein, attorneys fees and costs are hereby the party on whose declarant in the sum of $_______________. The Courtpenalty of $50 and make said awarded to the behalf this subpoena was issued for a maximum is hereby directed to all damages sustained as a result payment failure to comply. of your to the above declarant. Dated:_______________ Reviewed by Commissioner:_____(initial only plese) Witness, Honorable Court in County, , one of the Justices of the day of ___________________________________________ , 20 Authorized Signature SAP CODING STRIP _______________________ SAP DOCUMENT NUMBER VENDOR NUMBER:_______________________ COST CENTER Line 1 Line 2 Line 3 502550 502550 502550 (Attorney must sign above and type name below) 110001 FUND 50 PLANT INV NO:____________________ Attorney(s) for G/L G/L ACCOUNT AMOUNT DESCRIPTION Office and P.O. Address Children 938801 Parents/Guardian 938802 CAC Sec 3150 938803 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: ________________________________Approved for Payment G006 Rev 02/04 American LegalNet, Inc. www.USCourtForms.com