COUNTY COURT, PINELLAS COUNTY, FLORIDA SMALL CLAIMS DIVISION UCN: ______________________________ Reference No.: ______________________________ ________________________________________________ ________________________________________________ Plaintiff(s) vs. ________________________________________________ ________________________________________________ Defendant(s) SUBPOENA THE STATE OF FLORIDA: Type in boxes to left: Name, Street Address, City/State/Zip of Person to be Subpoenaed TO: YOU ARE HEREBY COMMANDED to appear before the Honorable ___________________________________ , Judge of the Court, at the Pinellas County Courthouse in _______________________________________________ , Florida, on _____________________ , 20 _____ , at _______ M., to testify in this action. If you fail to appear, you may be in contempt of Court. You are subpoenaed to appear by the following party/attorney and unless excused from this subpoena by this party/attorney or the Court, you shall respond to this subpoena as directed. WITNESS my hand and the seal of this Court on _____________________________ , 20 ______ . KEN BURKE (SEAL) Clerk of the Circuit Court By: ________________________________________ Deputy Clerk ______________________________________________ Plaintiff/Defendant or Attorney for Plaintiff/Defendant ______________________________________________ Address ______________________________________________ Phone No.: SC 022 (Rev. 8/2009) If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact the Human Rights Office, 400 S. Fort Harrison Ave., Ste. 300, Clearwater, FL 33756, (727) 464-4062 within 2 working days of your receipt of this Subpoena; if you are hearing or voice impaired, call 1-800-955-8771. SC022 American LegalNet, Inc. www.FormsWorkFlow.com 12/04