IN THE CIRCUIT COURT OF BUTLER COUNTY, MISSOURI Judge or Division: Case Number: Plaintiff(s): Person Subpoenaed: Plaintiff’s Attorney: Address: Address: vs. Defendant(s): Telephone: Defendant’s Attorney: Requesting Party: Pltfs Attny Pltf Def Attny Def Address (of party checked above): (Date File Stamp) Address: Telephone: Telephone: Subpoena Order to Appear/Produce Documents/Give Depositions The State of Missouri to :___________________________________________________(person subpoenaed). You are commanded: to contact _____________________________________(name) at _____________________________(telephone) who will advise of time and place appearance is required. to appear at ____________________________________________________________________________________ on _______________________________________(date), at __________________________(time). to testify on behalf of ____________________________________________________________________________ . to give depositions. to bring the following: ___________________________________________________________________________ ______________________________________________________________________________________________ _______________________________________________________________ (Attach additional sheet if necessary.) (Seal) BETTY SCOTT, CIRCUIT CLERK ___________________________________________________ By: , Deputy Clerk Return/Affidavit I certify that I served this subpoena in ______________________________________________ County, Missouri by: delivering a copy to the person subpoenaed. reading a copy to the person subpoenaed on ___________________________(date). _________________________________________________ Person serving subpoena OSCA (9-95) MU95 1 of 2 37.55 RSMo American LegalNet, Inc. www.FormsWorkFlow.com Instructions 1. This subpoena will remain in effect until this trial is concluded or you are discharged by the Court. You must attend trial from time to time as directed. No additional subpoena is required for your future appearance at any trial of this case. If you fail to appear, you may be held in contempt of court. 2. If you have any questions regarding this subpoena, contact the person who requested it listed on the front. 3. Bring this form with you to court. This form must be completed, signed, and returned to the clerk as soon as you have testified or been dismissed. Witness Claim I have served ______________________ day(s) as a witness and I traveled ______________________ mile(s) round trip from my home to the courthouse to attend this proceeding. ____________________________________________________ Signature ____________________________________________________ Current Address ____________________________________________________ City, State, Zip Subscribed and sworn to before me __________________________________ (date) ____________________________________________________ Clerk Total Claimed $ ______________________ OSCA (9-95) MU95 By: ________________________________________________ Deputy Clerk 2 of 2 37.55 RSMo American LegalNet, Inc. www.FormsWorkFlow.com