COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : Plaintiff(s) Index No. Calendar No. INVOICE NUMBER: Vital Records Collection Form : -against: : : JUDICIAL SUBPOENA Date: Docket Number: Defendant(s) Social Security information is required for all Divorce, Annulment, Child Support, And Paternity : ...................................................... issues within the District of Columbia Courts Pursuant to D.C. Act 13-126, as amended by the Vital Records Act of 1991. You will need to provide, SSN information for all parties and minor . children involved, in this case. THE PEOPLE OF THE STATE OF NEW YORK . Please provide the following information as Part of your filing: TO Plaintiff: GREETINGS: Name: Name: Social Security #: Social Security #: Social Security #: Plaintiff: Defendant Name: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Social Court Security #: Defendant Name: , the Honorable at the located at County of Social Security #: Child Name: in room , on the day of , 20 , at o'clock in the noon, and at any recessed Social Security #: Child Name: or adjourned date, to testify and give evidence as a witness in this action on the part of the Child Child Name: Name: Social Security #: Social Security #: 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. Please indicate below what issues are involved in this case. Court in Witness, Honorable County, , one of the Justices of the day of , 20 DIVORCE ANNULMENT CHILD SUPPORT (Attorney must sign above and type name below) PATERNITY This information will be placed in a secure of our docketed record section and available only to authorized D.C. Government Agencies. Once a divorce, annulment, child support, paternity issue is determined, this information will be forwarded to the D.C. Vital Statistics office in Office and P.O. Address conjunction with a form DHS-1601 (7/97), as required by the law. Attorney(s) for Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com