COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : JUDICIAL Plaintiff(s) DISTRICT COURT OF SHAWNEE COUNTY, KANSASSUBPOENA -against- : : : Case No. **COURT CASE #** **CAPTION** Defendant(s) : .. vs.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Document No._________ APPLICATION FOR APPOINTED DEFENSE SERVICES THE PEOPLE OF THE STATE OF NEW YORK (To accompany Financial Affidavit) TO NOTICE TO APPLICANT: A. General Information GREETINGS: 1. The information on the attached affidavit is not confidential. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 2. False entries may lead to criminal prosecution and conviction. Court , the Honorable at the located at County of 3. If you do not understand a specific question or need help, ask for assistance. in room , on the day of , 20 , at 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 4. The judge or hearing officer may place you under oath and inquire further about any information provided on this form. B. Eligibility for Defense Services 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 1. Appointed failure to and other defense services will only be provided to people who cannot afford to result of your counsel comply. pay for these services themselves. , one of less than it is worth, 2. If, afterWitness, Honorable the date of the alleged offense, you transfer any of your property for the Justices of the the State mayin to obtain repayment of day cost of your defense. the of Court sue County, , 20 3. You must inform the court if there is a change in any of the financial information given on the Affidavit. (Attorney must sign above I have read or have had read to me and understand the above notice and the attached and type name below) Financial Affidavit. I further state that I am of lawful age and that under penalty of perjury I declare that the information I have provided on the Financial Affidavit is true, and I hearby request that court-appointed counsel be provided to me. Attorney(s) for ____________________ _______________________________________________ Date Signature of Applicant Subscribed and sworn to before me this _______ day of __________________________, 20___. Office and P.O. Address My commission expires _____________________ ________________________________ Notary Public / Deputy Clerk Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com