COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA -against: AUTHORIZATION TO DISCLOSE FINANCIAL RECORDS : To: ____________________________________ ____________________________________ Defendant(s) ____________________________________ : : ...................................................... Re: ____________________________________ Social Security No. THE PEOPLE OF THE STATE OF NEW YORK You are hereby authorized and directed to furnish and release to ____________________ TO to any employee, agent or representative thereof any and all or any portion of the records, and documents and other writings and information in your possession or under your control concerning all of my accounts with and deposits in your institution, whether open or closed, and whether held solely in my name or jointly with another and further concerning all my loans and GREETINGS: lines of credit with your institution on which I am liable individually or jointly with another or as a guarantor. 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 ofYou are further authorized to allow said persons to read, review, copy and have copied inany and all records, notations, of room , on the day memoranda, , and all at 20 , other recorded in the o'clock information regardless of noon, and at any recessed whether itdate, to testify and give evidence as computerized disc. on the part ofalso authorized to is written, recorded, or on a witness in this action You are the or adjourned communicate with said persons orally or in writing and to provide reports concerning the matters addressed herein for the purpose of explaining or disclosing any other information requested relative to such accounts and deposits. 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 All expense pertaining to the foregoing shall be paid by the party requesting the result of your failure to comply. information pursuant to this authorization and nothing herein shall be construed to make me liable for those costs. Witness, Honorable Court in County, STATE OF MISSOURI COUNTY OF , one of the Justices of the day of ) ) ss ) , 20 __________________________________________ (Attorney must sign above and type name below) Attorney(s) for On this ____ day of ___________, _____, before me a Notary Public, personally appeared the above named person who acknowledged signing the above and foregoing instrument as a free act and deed. Office and P.O. Address __________________________________________ Notary Public My Commission Expires: 38th Circuit Form 8 (Rev. 1-1-2000) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com