COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : _______________________________ Plaintiff(s) Name -against_____________________________________ Address _____________________________________ City State Zip Code _____________________________________ Phone Number Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) [ ] PETITIONER/[ ] RESPONDENT PRO SE : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK TO MONTANA _______________ JUDICIAL DISTRICT COURT _____________________ COUNTY GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before In re the Marriage of: , the Honorable at the Court Cause No.: _________________ located at County of ________________________, of in room , on the day , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testifyPetitioner, and give evidence as a witness in this action on the part of the [ ] Petitioner’s/[ ] Respondent’s [ ] Preliminary/[ ] Final Declaration of Disclosure of Assets, Your failure to comply with ________________________, this subpoena is punishable as aIncome, andcourt and will make you liable to Debts, contempt of Expenses the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Respondent. result of your failure to comply. and Witness, Honorable Court in County, , one of the Justices of the day of , 20 Warning: Montana law, M.C.A. § 40-4-252, requires the full disclosure of all assets, debts, income, and expenses. Failure of either party to file a complete financial disclosure statement shall authorize the Court to accept the statement of the other party as accurate. Any (Attorney must sign above and type name below) deliberately false statement made hereon or on any schedules or attachments may subject you to the penalty of perjury or other appropriate relief and may be considered a fraud upon the Court. Attorney(s) for If you need additional space on which to list your assets, debts, income, or expenses, please attach additional sheets of paper as necessary. Do not write in the margins or on the reverse sides of the pages of this document. Office and P.O. Address Telephone No.: Facsimile No.: Declaration of Disclosure, Page 1 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : 1. Disclosure of Assets a. Plaintiff(s) Real Estate -against- Description Calendar No. : JUDICIAL SUBPOENA : Estimated. : Value Name(s) on Title : Defendant(s) Address: ___________________________________ : ...................................................... Legal Description:____________________________ ___________________________________________ Is there a secured debt on the property? [ ] Yes [ ] No THE PEOPLE OF THE STATE OF NEW YORK / / If yes, amount owed: __________ As of: Lender: ____________________________________ TO Address: ___________________________________ GREETINGS: Legal Description:____________________________ ___________________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Is there a secured debt on the property? [ ] Yes [ ] No , the Honorable at the Court If yes, / / located at County of amount owed: __________ As of: Lender: ____________________________________at in room , on the day of , 20 , 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 b. Vehicle(s) 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 Description Estimated Value Name(s) on Title result of your failure to comply. Witness, Honorable Year/Make/Model: ___________________________ Court in _____________________________________ County, day of , 20 VIN#: Is there an outstanding loan on the vehicle? [ ] Yes [ ] No If yes, amount owed: _____________ Lender: _____________________ As of: / / Year/Make/Model: ___________________________ VIN#: _____________________________________ Is there an outstanding loan on the vehicle? [ ] Yes [ ] No If yes, amount owed: _____________ As of: / / Lender: _____________________ , one of the Justices of the (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: Declaration of Disclosure, Page 2 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Description Plaintiff(s) -against- Index No. Calendar No. : JUDICIAL SUBPOENA Estimated Value Name(s) on Title : Year/Make/Model: ___________________________ VIN#: _____________________________________ Is there an outstanding loan on the vehicle? [ ] Yes [ ] No If yes, amount owed: _____________ Defendant(s) As of: / / Lender: _____________________ : : : ...................................................... Year/Make/Model: STATE OF NEW YORK THE PEOPLE OF THE ___________________________ VIN#: _____________________________________ TOIs there an outstanding loan on the vehicle? [ ] Yes [ ] No If yes, amount owed: _____________ As of: / / Lender: _____________________ GREETINGS: c. Bank Accounts and business and excuses being laid aside, you and each of you attend before WE COMMAND YOU, that allCash , the Honorable at the Court located at account County of Description (include name of bank and Balance as of Name(s) on in room , on the day of , 20 , at o'clock in the Account and at any recessed noon, / / number) 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. Cash Witness, Honorable Court in County, d. , one ofXXXXXXXXthe the Justices of day of , 20 Pensions/Retirement Accounts; Life Insurance (Cash Value); Stocks, Bonds, Secured Notes, Mutual Funds (Attorney must sign above and type name below) Description Estimated Value Attorney(s) for Name(s) on Account Office and P.O. Address e. Personal Property (including appliances, furniture, jewelry, art, guns, etc.) Telephone No.: Facsimile No.: Declaration of Disclosure, Page 3 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Description Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA Estimated Value : : : Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK 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. 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 f. Business Interests (including equipment, tools, livestock, etc.) Telephone No.: Facsimile No.: Declaration of Disclosure, Page 4 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Description Plaintiff(s) -against- Index No. Calendar No. : JUDICIAL SUBPOENA Estimated Value Name(s) on Title : : : Defendant(s) : ...................................................... g. Other Assets THE PEOPLE OF THE STATE OF NEW YORK Description Estimated Value Name(s) on Title 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 2. Disclosure of Debts Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Creditor Amount Name damages theDescription party on whose behalf this subpoena was issued for a maximum penalty of $50 and all on Debt sustained as a Owed result of your failure to comply. Secured Debt on Real (See 1(a) above) Witness, Honorable Property Court in Vehicle Loan(s) Utility Bill(s): County, day of (See 1(b) above) XXXXX XXXXXXXXX XXXXX XXXXXXXXX , one of the Justices of the , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: Declaration of Disclosure, Page 5 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Description Creditor Plaintiff(s) -against- : : Credit Card(s): Index No. Calendar No. JUDICIAL SUBPOENA Amount Name on Debt Owed : : Defendant(s) : ...................................................... Student Loan(s): THE PEOPLE OF THE STATE OF NEW YORK TOMedical Expenses: GREETINGS: Other Liabilities: 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 3. Disclosure of Income result of your failure to comply. The [ ]Petitioner/ [ ]Respondent has the following income: Witness, Honorable Source Court in of IncomeCounty, , one of the Justices of the day of , 20 Amount per Month Gross Wages, Salary, Commissions Rents, Interests, Dividends (Attorney must sign above and type name below) Self Employment Earnings Unemployment or Worker’s Compensation Attorney(s) for Social Security Benefits, including SSI Public Assistance Food Stamps Office and P.O. Address Pension, Retirement Telephone No.: Facsimile No.: Declaration of Disclosure, Page 6 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Source of Income Plaintiff(s) -against- Child Support : Index No. Calendar No. JUDICIAL SUBPOENA Amount per Month : Dependent’s Benefits : Other Income (describe): : Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK 4. TO Disclosure of Expenses The [ ] Petitioner/[ ] Respondent has the following expenses: Amount per Month Description of Expense GREETINGS: Taxes and other money withheld from income WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , theRetirement Honorable at the Court located at County of Health in room Insurance (self and children) , 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 Medical Expenses Housing (rent or mortgage payment) Your failure Property Taxes 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 yourInsurance comply. Property failure to Transportation Honorable Witness, Court in Car Insurance County, , one of the Justices of the day of , 20 Student Loans Utilities (Attorney must sign above and type name below) Telephone Clothing Attorney(s) for Food and Household Supplies Child Care Office and P.O. Address Child Support Payments Telephone No.: Facsimile No.: Declaration of Disclosure, Page 7 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Description of Expense Plaintiff(s) -againstOther Expenses (describe): : Index No. Calendar No. JUDICIAL SUBPOENA Amount per Month : : : Defendant(s) : ...................................................... DATED this ____ day of _______________________, 20___. THE PEOPLE OF THE STATE OF NEW YORK Signature TO Print Name [ ]Petitioner/ [ ]Respondent Pro Se GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable MONTANA at the Court STATE OF ) located at ss. County of ) inCOUNTY OF , on the room 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 SUBSCRIBED AND SWORN TO before me this _____ day of ____________________, 20____. 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 (Seal) County, day of , one of the Justices of Name (printed): _______________________the Notary Public for the State of Montana , 20 Residing at My commission expires (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: Declaration of Disclosure, Page 8 of 8 E-Mail Legal Services Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Address: Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com