COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Attorney/Debtor Name, Address, Phone, Fax, E-mail: : : Plaintiff(s) -against- Index No. For court use only Calendar No. JUDICIAL SUBPOENA : : UNITED STATES BANKRUPTCY COURT DISTRICT OF HAWAII : Defendant(s) : Debtor: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... Case No. Chapter 13 and, if any, Joint Debtor: APPLICATION FOR ORDER TO EMPLOYER TO PAY FUNDS TO TRUSTEE ( THE PEOPLE OF THE STATE OF NEW YORK Amended ) TO The Debtor/Joint Debtor has a case pending under Chapter 13 of the Bankruptcy Code and agrees to submit wages or other income in the amount below to the supervision and control of the Trustee. The Debtor/Joint Debtor hereby requests that such portion of wages or other income be paid directly to the Trustee by the employer identified below. GREETINGS: Dated: ____________________ ________________________________________ Signature of Debtor / Joint Debtor / Attorney 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 ORDER ,( 20 Amended ) o'clock in the , at noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the IT IS HEREBY ORDERED: Name and address of employer of Debtor Joint Debtor 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 is directed, until further court order or until notification by the court or the Trustee that this case has been converted to another chapter under the Bankruptcy Code or has been dismissed, to deduct monthly from wages or other income the amount below and to pay such sum, whether monthly, bimonthly, biweekly or weekly, to the Trustee. (Attorney must sign above and type name below) Amount: $ Howard M.S. Hu, Chapter 13 Trustee 1132 Bishop Street, Suite 301 Attorney(s) Honolulu, Hawaii 96813 for Payroll deductions for matters such as current income tax withholding, social security, disability, insurance premiums, union dues and mandatory retirement contributions, are not affected by this order and may be continued. Office and P.O. Address Funds sent to the Trustee shall be identified with the Debtor’s name and case number. The employer shall notify the Trustee promptly of any change in employment status affecting compliance with this order. Dated: ____________________ hib_1322a1 3/03 Telephone No.: Facsimile No.: _______________________________________ E-Mail Address: United States Bankruptcy Judge Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com