COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. CIRCUIT COURT OF CLAY COUNTY, MISSOURI : JUDICIAL SUBPOENA Plaintiff(s) PROBATE DIVISION -against: No.__________________ : Matter of _______________________________________, deceased. : APPLICATION FOR SUPPORT ALLOWANCE IN PENDING ESTATE Defendant(s) (Sec. 474.260 and 474.163 RSMo.) : ...................................................... The applicant herein states that:___________________________________ age_____, who died on, was survived by *a spouse *and ____ child___, of who ___ are unmarried minors. The following children, THE deceased, are not the THE PEOPLE OFof the STATE OF NEW YORKchildren of the surviving spouse: Name Age Address Name Age Address Name GREETINGS: Age Address TO Pursuant to Sections 474.260 and 474.163 RSMo., the aggregate value of all money or property WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before derived from the decedent passing to the surviving spouse *and unmarried minor child____, other than the , the Honorable at the Court property listed in this application, without full consideration in money or money’s worth, including any located at County of allowances which may be made in other jurisdictions and satisfied from property therein, is in room $______________, asday of , on the , 20 at o'clock of this noon, itemized on Exhibit A on, the reverse sidein the form. and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the After considering such aggregate value, *the spouse *and *the minor___ *is/are entitled to a reasonable allowance of $_____________________, out of the probate estate of the decedent as a support allowance. to comply with this subpoena is punishable as a contempt of court and will make you liable to Your failure the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Wherefore, the result of your failure to comply. applicant requests that a support allowance in the amount of $_________________, be allowed to__________________________________. Witness, Honorable , one of the Justices of MADE UNDER OATH THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT AREthe Court inAND ARE TRUE AND CORRECT TO THE , 20 OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND County, day of BEST THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Date:______________ (Attorney must sign above and type name below) Signature of Applicant_________________________________________ Address____________________________________________________ Attorney(s) for ___________________________________________________________ Phone No.__________________________________________________ *strike if inapplicable Form 527-D Revised 3/17/2003 Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Page 1 of 2 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. EXHIBIT A : JUDICIAL SUBPOENA Plaintiff(s) Property received -against- and unmarried minor child_____ from decedent by by spouse : joint ownership or as beneficiary, etc., as provided in Sections 474.260 and 474.163 RSMo. : : Real Estate: (Land, Houses, Buildings)______________________________ Accounts in Banks, Savings & Loans, etc.____________________________ Defendant(s) : ...................................................... Stocks and Bonds________________________________________________ NET VALUE __________________ __________________ As Beneficiary of Insurance________________________________________ As OF THE STATE OF NEW YORK THE PEOPLE Beneficiary of Pension or Annuity Funds__________________________ All Other Such Property__________________________________________ TO Total Net Value __________________ GREETINGS: 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 the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Form 527-D Revised 3/17/2003 Telephone No.: Facsimile No.: E-Mail Address: Page 2 of 2 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com