SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT THE PEOPLE OF THE STATE OF NEW YORK INTAKE/CROSS REFERENCE SHEET Branch/Agency Docket Number: TO Please provide the following information concerning the party(s) immediate family and household members in order to assist the court m processing your case. Child Name: Current Address GREETINGS: Natural Mother: Current Address Natural Father: Current Address 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 D.O.B. D.O.B. D.O.B. in room , on the day of , 20 , at o'clock in the noon, and at any recessed If known, provide the following information: If known, provide the following information:or adjourned date, to testify and give evidence as a witnessIf known, provide the following information: in this action on the part of the IV-D UPI SFN: IV-D UPI IV-D UPI Other's Name Relationship to Child Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on Name behalf this subpoena was issued for a Other's Name maximum penalty of $50 and all damages sustained as a Other's whose result of your failure to comply. Relationship to Child Relationship to Child Witness, Honorable Court in County, Current Address Current Address Current Address day of , 20 , one of the Justices of the D.O.B. If known, provide the following information: IV-D UPI SFN: D.O.B. If known, provide the following information: IV-D UPI SFN: D.O.B. If known, provide the following information: (Attorney must sign above and type name below) IV-D UPI SFN: . Please list other court matters involving this family and household members that you are aware of (Child Support, Paternity, Domestic Violence, Custody, Delinquency, Neglect Attorney(s) for Divorce, Mental Health, Criminal, and Civil ) PARTY(S) NAME TYPE OF CASE A ND DOCKET NUMBER WHERE WAS THE CASE FILED? WHAT WAS THE OU TC OME OF THE CASE? IS THE CASE STILL OPEN? IF OPEN, NEXT HEARING DATE, IF KNOWN? Office and P.O. Address (Yes) (No) (Yes) (No) Telephone No.: (Yes) (No) Facsimile No.: (Yes) (No) E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com I Defendant(s) : ...................................................... FOR OFFICE USE ONLY COMPUTER SEARCH OF SYSTEM FOR RELATED CASES. SYSTEM Docket Number(s), Social Files Number, PDID Number SEARCHED Neglect THE PEOPLE OF THE STATE OF NEW YORK TO Clerks Name NEXT HEARING DATE FOUND HIT: Notice Forwarded (Date) Juvenile 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 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 Domestic Relations Paternity & Support Adoption 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 Court in County, , one of the Justices of the day of , 20 MH & MR Domestic Violence (Attorney must sign above and type name below) Criminal Attorney(s) for Civil Office and P.O. Address . Other Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com I