COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. CIRCUIT COURT OF CLAY COUNTY, MISSOURI : Calendar PROBATE DIVISION No. Plaintiff(s) In the Matter of -against- : No. JUDICIAL SUBPOENA : a Minor - Protectee. : PETITION TO TERMINATE GUARDIANSHIP : The Applicant, , states to the Court that: Defendant(s) : . . . . . . . . . . . .1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., a minor whose is . years old is under guardianship in Clay County, Missouri and that , is guardian of . THE PEOPLE OF THE STATE OF NEW YORK 2. The Applicant hereby request that the guardianship be terminated for the following reasons: TO 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. (if you don’t Witness, Honorable have enough space continue on the back) one of the Justices of the , Court in County, day of , 20 WHEREFORE, the applicant requests that the guardianship of , be terminated and custody be given to (Attorney must sign above and type name below) , upon the signing of the Order to Terminate. THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO MY BEST KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE Attorney(s) for MADE SUBJECT TO THE PENALITES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Applicant’s Signature Office and Address P.O. Address __ _ Phone ____________________________________ Telephone Attorney No.: __ _ Facsimile No.: _ E-Mail Address: Bar No. Tel. No.: Mobile ______________ Phone No. ____________ Dated Form 255 Revised 3/25/2004 Page 1 American LegalNet, Inc. www.USCourtForms.com