COURT PETITIONER PARISH/CITY OF V. STATE OF LOUISIANA DIVISION: FILED: DEFENDANT NUMBER: CLERK: COURT COUNTY . . CONFIDENTIAL . . . . . . . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ADDRESS FORM : TO BE USED WHEN PETITIONER DOES NOT Index No. WANT DEFENDANT TO LEARN ADDRESS : Calendar No. PETITION FOR PROTECTION FROM ABUSE : JUDICIAL Art. 1564, et seq. Pursuant to La. R.S. 46:2131, et seq., La. R.S. 46:2151, La. R.S. 13:4248 or La. Ch. C.SUBPOENA Plaintiff(s) -against: The petition of _______________________________________, born ________________________ your name : a domiciliary of the State of _____________________, respectfully represents: : month, day, year Paragraph 1 Defendant(s) : . . . . . Petitioner .files . . . . petition .on behalf. of: . . . . . . . . . . . . . . . . . . . . . . . . . . . this . . . . . . . . . . . . . . . a. ____ Petitioner, and/or b. ____ Minor child(ren) as follows: THE PEOPLE OF THE STATE OF NEW YORK Name Relationship to petitioner DOB Relationship to petitioner Name GREETINGS: DOB Name TO DOB Relationship to petitioner Name DOB Relationship to petitioner c. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before ____ Alleged incompetent: , the Honorable at the Court Name DOB Relationship to petitioner located at County of in room , on day of , 20 DOB at , o'clock in the to petitionerand at any recessed noon, Namethe Relationship or adjourned date, to testify and give evidence as a witness in this action on the part of the Paragraph 2 Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Petitioner’s current mailing address: 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. _______________________________________________________________________ No. & Street Apt. No. Witness, Honorable , one of the Justices of the _______________________________________________________________________ Court in County, day of , 20 City State Zip Code The minor child’s or alleged incompetent’s current address: (Attorney must sign above and type name below) _______________________________________________________________________ No. & Street Apt. No. _______________________________________________________________________ Attorney(s) for City State Zip Code THIS COVER SHEET IS TO BE FILED UNDER SEAL AND ITS CONTENTS TO REMAIN Office and P.O. Address CONFIDENTIAL TO THE COURT PURSUANT TO LA. R.S. 46:2134(B), R.S. 13:4243(B), or Ch. C. Art. 1568(b). Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: LPOR F v.4 American LegalNet, Inc. www.USCourtForms.com