COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION : JUDICIAL SUBPOENA No.__________________ Plaintiff(s) Matter of -against- : , Minor . : AFFIDAVIT (Sec.452.445 and .480 RSMo.) : Defendant(s) : . . . . . . . . . . . . . . .The . . . . . . . . . information. is. true .to. the. best. of my knowledge and belief and is submitted in . . . following . . . . . . . . . . . . . . . . . . . . . regard to the petition for guardianship of the above named minor 1. Minor presently living with at . THE PEOPLE OF THE STATE OF NEW YORK TO 2. Minor the past six months: lived with the following other persons at the following addresses within GREETINGS: 3. I *have *have not participated in other litigation concerning the custody of above minor in this orYOU, that all business and excuses being laid aside, you and each of you attend before WE COMMAND another state. (If you have, explain in detail.) , 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 minor 4. I *have *have no information of any custody proceeding concerning the pending in a court of this or any other state. (If you have, explain in detail.) 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. 5. I *have *have no knowledge of any person, not a party to these proceedings, who Witness, Honorable , one of the Justices of the has physical custody of the minor , or claims to have legal custody or visitation rights with respect Court in to the minorCounty, you have, explain in detail.) day of , 20 . (If (Attorney must sign above and type name below) Attorney(s) for Affiant’s Signature Address Phone Office and P.O. Address Signed and sworn to before me this (seal) day __of 20______. Telephone No.: *strike if inapplicable Form 101M Revised 3/14/2003 Notary Facsimile No.: Deputy Clerk E-Mail Address: Page 1 of 1Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com