COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : STATE OF GEORGIA : Index No. Calendar No. Report of Divorce, Annulment or Dissolution of Marriage Type or print all information : Plaintiff(s) JUDICIAL SUBPOENA -against- Decree Granted (mo., day, year) 2. Date : 1. Civil Action Number 3. County Decree Granted : 4. Wife’s Name (first, middle, last) . Residence 7. County .of . . . . . . . . 5. Maiden (Birth) Last Name : 6. Date of Birth (mo., day, year) Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8. .Number .of . . . Marriage (1st, 2nd, etc.) . . . . . . . This 9. Husband’s Name (first, middle, last, generation) THE PEOPLE OF THE STATE OF NEW YORK 10. Date of Birth (mo., day, year) 11. County of Residence TO 12. Number of This Marriage (1st, 2nd, etc.) 13. Date of This Marriage (mo., day, year) GREETINGS: 14. Specify Grounds For Divorce (19-5-3, OCGA) 15. Number of Children Less Than 18 Affected by This Decree 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 Thisor adjourned date, to be reproduced by use ofas computer. However, the the part of the must be a close above Report may testify and give evidence a a witness in this action on finished Report reproduction of the original, and prior review and approval must be obtained from the State Registrar before use. (31-10-7, O.C.G.A.) 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 dissolutions, and annulments. and all damages sustained as a 31-10-22. Record of divorce, for a maximum penalty of $50 result of your failure to comply. (a) A record of each divorce, dissolution of marriage, or annulment Witness, Honorable , one of the Justices of the granted by any court of competent jurisdiction in this state shall be filed Court in County, day of , 20 by the clerk of the court with the department and shall be registered if it has been completed and filed in accordance with this Code section. The record shall be prepared by the petitioner or the petitioner’s legal (Attorney the sign above and type representative on a form prescribed and furnished by must state registrar name below) and shall be presented to the clerk of the court with the petition. In all cases, the completed record shall be a prerequisite to the granting Attorney(s) for of the final decree. (b) The clerk of the superior court shall complete and forward to the department on or before the tenth day of each calendar month the Office and P.O. Address records of each divorce, dissolution of marriage, or annulment decree granted during the preceding calendar month. Form 3907 (Rev. 10-2002) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com