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Interrogatories Form. This is a Missouri form and can be use in 21st Circuit (St. Louis County) Local Circuit Courts.
Tags: Interrogatories, Missouri Local Circuit Courts, 21st Circuit (St. Louis County)
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Index No.
Calendar No.
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IN THE PROBATE DIVISION, CIRCUIT COURT
JUDICIAL SUBPOENA
Plaintiff(s)
ST. LOUIS COUNTY, MISSOURI
-against:
In the matter of:
:
__________________________________________
Respondent
Estate No.
:
Defendant(s)
:
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Deposition of ________________________________________________
On this ______ day of__________________, 2_____, before me,________________________,
THE PEOPLE OF THE STATE OF NEW YORK
a Notary Public within and for the County of ______________, State of Missouri, personally
TO
appeared ____________________________, who, after being sworn, testified as follows:
INTERROGATORIES
GREETINGS:
1.
Q. Please state YOU, that all business and excuses
WE COMMAND your name, age and residence. being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County ofA.
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
2.
Q. What is your occupation, business or profession?
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
A.
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.
3.
Court in
Q. Are Honorable to practice medicine in the State of Missouri?of the Justices of the
Witness, you licensed
, one
A.
County,
day of
, 20
(Attorney must sign above and type name below)
4.
Q. If your answer to Interrogatory number 3 above is affirmative, is your license subject
to any restrictions imposed by the Board of Healing Arts of the State of Missouri?
Attorney(s) for
A.
Office and P.O. Address
5.
Q. Where are you employed and in what capacity?
A.
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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6.
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Q. Are you acquainted with ____________________? JUDICIAL SUBPOENA
Plaintiff(s)
A.
-against-
:
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7.
:
Q. Have you had occasion to examine, observe and treat ____________________?
Defendant(s)
:
. . . . . . . . A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..
THE PEOPLE OF THE STATE OF NEW YORK
8.
TO
Q. What was the date of such examination, or between what dates has
________________________ been under your supervision?
A.
GREETINGS:
WE COMMAND YOU, that all businessyou observed and laid aside,neurological and mental before
9.
Q. Give the symptomatology which and excuses being both the you and each of you attend
,
the Honorable diagnoses which you have made, based upon your examination and observation of
at the
Court
located at
County of
________________________.
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
PLEASE STATE FULLY THE FACTS UPON WHICH YOUR DIAGNOSTIC
CONCLUSIONS ARE BASED – NOT ACCEPTABLE AS EVIDENCE OTHERWISE.
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 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
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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10.
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Q. Do you consider _____________________ to be “disabled,” that is,SUBPOENA
JUDICIAL unable by reason
Plaintiff(s)
of any physical or mental condition to receive and evaluate information or to
-against:
communicate decisions to such an extent that he/she lacks ability to manage her
financial affairs?
:
A.
:
Defendant(s)
:
......................................................
11.
Q. Please describe the physical and/or mental conditions upon which your answer to
Interrogatory 10 is based.
THE PEOPLE OF THE STATE OF NEW YORK
A.
TO
12.
Q.
Do you consider _____________________ to be “incapacitated,” that is, unable by
GREETINGS: reason of any physical or mental condition to receive and evaluate information or to
communicate decisions to such an extent that he/she lacks ability to meet his/her
WE COMMAND YOU, that all businessclothing, shelter, safety, or medical care such that
essential requirements for food, and excuses being laid aside, you and each of you attend before
,
the Honorable serious physical injury, illness, orat the is likely to occur were a guardian not
Court
disease
located at
County of
appointed for him/her?
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
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 and/or for a maximum penalty ofwhich your answer to
13.
Q. Please describe the physical issued mental conditions upon $50 and all damages sustained as a
result of your failure to comply. is based.
Interrogatory 12
Witness, Honorable
A.
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
14.
Q.
A.
Attorney(s) for
Do you consider it for ____________________’s best interest to bring about the
appointment of a guardian to protect his/her person?
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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15.
Q.
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Do you consider it for _____________________’s best interest to bring about the
JUDICIAL SUBPOENA
Plaintiff(s)
appointment of a conservator to manage his/her resources?
-against-
:
:
A.
:
16.
Q. Do you consider _____________________ to be “incompetent,” i.e., of unsound
Defendant(s)
:
. . . . . . . . . . . . mind?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.....
A.
THE PEOPLE OF THE STATE OF NEW YORK
TO
17.
Q. State anything further you may have to say regarding the alleged disability,
incapacity, or incompetence of _____________________.
GREETINGS:
A.
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
or adjourned date, to testify and give evidence as a witness in this action on the part of the
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
Deponent the Justices of the
day of
, 20
KNOW ALL MEN BY THESE PRESENTS, that I, the undersigned Notary Public
hereby certify that the above named Deponent was first duly sworn by me to make the true
(Attorney must sign above and type name below)
answers to the foregoing interrogatories; that said interrogatories were read by me to Deponent;
that the answers thereto are correctly recorded as hereinabove set forth; and that this deposition
was subscribed by the Deponent in my presence.
Attorney(s) for
__________________________________________
Notary Public
Office and P.O. Address
My commission expires: _______________
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
