COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : F 3.201(2)C Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA (Requests for Production from Plaintiff to Defendant) -against: : 1. Any and all policies of insurance, including the declaration pages, which may provide : coverage to the defendant for the injury and damage alleged by the plaintiff, it is intended that this Defendant(s) : . .include .all. primary . . . . excess. insurance .policies.. . . . . . . . . . . . . . . . . . . . . . . . . and . . . . . . . . . . . . . . . . . . . 2. Any and all statements obtained from any witness who was or claims to have relevant information on any issue which is the subject matter of this lawsuit. THE PEOPLE OF THE STATE OF NEW YORK 3. Any and all statements which were executed by the defendant and in any way concern TO the issues which are the subject matter of this lawsuit. 4. Any and all statements which the plaintiff may have made to anyone which in any way GREETINGS: issues which are the subject matter of this lawsuit. concern the 5. Any and all reports business and excuses being laid aside, you enforcement agency WE COMMAND YOU, that allor other documents prepared by a law and each of you attend before , the Honorable at the Court concerning the subject occurrence. located at County of Any the all reports or other documentsat in room 6. , on and day of , 20 , prepared by the defendant concerning the 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 subject occurrence. 7. Any and all photographs of the scene of the occurrence which is the subject matter Your failure to comply with this the vehicles or objects involved or of court and object which of this lawsuit, of plaintiff’s injuries, of subpoena is punishable as a contempt of any other 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 may be relevant to to comply. result of your failure the issues in this lawsuit. It is intended that this request include any photographs whether taken by or in the possession of defendant’s insurance carrier, attorney or himself. Witness, Honorable , one of the Justices of the AnyCounty,documents, including photographs, dealing with or relating to vehicle or and all Court in 8. day of , 20 other property damage sustained in the occurrence which is the subject matter of this lawsuit including all documents dealing with or relating to repair(Attorney must sign above and typesalvage of the of the property damage, name below) property or replacement of the property. 9. Any and all reports or other documents made by any expert or lay person who Attorney(s) for reviewed or investigated this matter on behalf of the defendant or the defendant’s insurance company. 10. Any and all documents which defendant intends to use at the trial of this action. 11. Any and all documents of any insuranceOffice and P.O.adjusting company which company or Address reviewed or investigated the subject occurrence. 12. Telephone No.: Diagrams, reports, notes, specifications, records, written statements and photographs Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : regarding the subject occurrence contained in the investigative JUDICIAL SUBPOENA file of the defendant’s liability Plaintiff(s) insurance carrier. -against: 13. Any and all certificates of title and license registration documents for the automobile : involved in the occurrence which is the subject matter of this lawsuit. 14. : Your license(s) to operate or drive a motor vehicle. Defendant(s) : . . . . . . . . 15. . . . .Your. driving. record. for. each .state .in .which .you were licensed to drive or operate ... .... ...... ..... .. .... .... . ..... motor vehicles from five-years preceding the occurrence which is the subject matter of this lawsuit to the present. THE PEOPLE OF THE STATE OF NEW YORK 16. Any and all documents dealing with or relating to any prescription medicines or drugs TO you consumed or used during the 24 hour period immediately preceding the occurrence which is the subject matter of this lawsuit. GREETINGS: 17. Any and all repair bills, records, statements or logs during the period of three years prior toWE COMMAND YOU, that all business and excuses being laid aside, you and this lawsuit.attend before and one year subsequent to the occurrence which is the subject matter of each of you , the Honorable at Court 18. Any and all certificates or licenses the you to operate a commercial motor vehicle on for located at County of inthe date of the occurrence which of the subject, matter ,of this lawsuit. in the room , on the day is 20 at o'clock noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the 19. Any and all records or testimony given at a prior hearing regarding the occurrence which is the subject matter of this lawsuit. Your failure toagreement, compromise is punishable as a contempt of court andregarding you liable to 20. Any comply with this subpoena or arrangement with any person will make the the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a occurrence which is the subject matter of this lawsuit. result of your failure to comply. 21. Any and all medical records of defendant regarding a physical infirmity, disability or Witness, Honorable , one of the Justices of the sickness period Court in during theCounty, of three years prior and, one year subsequent to the occurrence which is day of 20 the subject matter of this lawsuit. 22. Any and all medical records regarding your eyeglassessign contact lenses. below) (Attorney must or above and type name 23. All documents which support your claim of comparative fault in this matter. 24. All documents which support your defenses in this matter. Attorney(s) for 25. The original records pertaining to the Plaintiff for the purposes of inspection, review and comparison to the photocopied records in possession of plaintiff. 26. Office and P.O. Address A copy of any reservations or rights issued to you by any insurers, which apply to this claim made in this matter. 27: Telephone No.: Any and all personal notes, memoranda, diaries, personal journals, appointment books, Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. reports, correspondence, notes and other documents which: wereJUDICIAL SUBPOENA by prepared and/or maintained Plaintiff(s) Defendant which relate in any way to the claims in this lawsuit. -against: 28 A copy of the charter of Defendant Hospital. 29. A copy of the bylaws of Defendant Hospital. 30. A copy of each exhibit listed on your preliminary and final exhibit list. : : Defendant(s) : . . . . . . . . 31. . . . .A .copy of .each.report,.statement, .or. transcript. of each and every interview conducted ... . ...... ... ..... ........ . ....... . in this matter other than those conducted by or at the direction of the attorney for defendant. 32. A copy of each statement given by the plaintiffs. 33. A copy of your most current C.V. in the form required by DCR 3.211. 34. A copy of any expert reports, summaries, notes, recordings, (including audio, video, THE PEOPLE OF THE STATE OF NEW YORK TO computer and other means of preservation) writings, or letters that you have obtained in this case GREETINGS: prepared in this case by such an expert or experts that may provide testimony at trial from or were that directly relates to or forms the opinions expressed bybeingexpert. The response shallyou attend before WE COMMAND YOU, that all business and excuses the laid aside, you and each of meet the , the Honorable at the Court requirements of DCR 3.211. located at County of Aon the of any depositions that20 have giveno'clock in the as an expert, or anya in the past in room 35. , copy day of , you , at noon, and at as recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the defendant in a medical negligence case. 36. A copy of any articles, texts, abstracts, or reports prepared by any experts which relate Your failure to comply with this subpoena is punishable as a contempt of court and to the subject matter of this litigation or the subject matter of the experts testimony. 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 37. A to comply. result of your failurecopy of each deposition given by each expert retained relating to the subject matter of this litigation. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Revised: 5-19-99 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com