COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA -against- CIRCUIT COURT OF CLAY COUNTY, MISSOURI : PROBATE DIVISION : No.____________________ : Defendant(s) : ...................................................... VERIFICATION OF RESTRICTED DEPOSIT OF SECURTIES , TRUST ESTATE The undersigned hereby certifies that ___he is an official of the below- named depository, whic h had on THEdeposit on the _____ day of _______________________, 20_____, the following described securities for PEOPLE OF THE STATE OF NEW YORK safekeeping in the name of , as TO Trustee___. Said deposits of securities have been made and accepted with the specific contract and agreement that they are subject to the order of the Probate Division of the Circuit Court of Clay County, Missouri and, no withdrawals will be permitted from such deposits except on the order of the Court. GREETINGS: Interest Stocks, Bonds, YOU, etc. Serial Nos. Date of Maturity WE COMMANDNotes, that all business and excuses beingRate aside, you and each of youFace Value if Any laid 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) THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Attorney(s) for Date________________ Depository Address Office and P.O. Address By:(signature) Title Form 706-T Revised 3/17/2003 Page 1 of 1 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com