COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : _______________________________ Plaintiff(s) Name -against_____________________________________ Address _____________________________________ City State Zip Code _____________________________________ Phone Number Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) WIFE, PETITIONER PRO SE : ...................................................... _______________________________ Name _____________________________________ Address THE PEOPLE OF THE STATE OF NEW YORK _____________________________________ City State Zip Code TO _____________________________________ Phone Number HUSBAND, PETITIONER PRO SE GREETINGS: MONTANA _______________ JUDICIAL DISTRICT COURT WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before _____________________ COUNTY , 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 In re the date, to testify or adjourned Marriage of: and give evidence as a witness in this action on the part of the Cause No.: _________________ ________________________, Petitioner, Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to [ ] Wife’s/[ ] Husband’s the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a and Final Declaration of Disclosure of result of your failure to comply. Assets, Debts, Income, and Expenses ________________________, Witness, Honorable Petitioner. Court in County, day of , one of the Justices of the , 20 Warning: Montana law requires the full disclosure of all assets, debts, income, and (Attorney must sign above and type name below) 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 deliberately false statement made hereon or on any schedules or attachments may subject Attorney(s) for you to the penalty of perjury or other appropriate relief and may be considered a fraud upon the Court. If you need additional space on which to list your assets, Office and P.O. Address 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. Telephone No.: Facsimile No.: E-Mail Address: Declaration of Disclosure, Page 1 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services 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.: E-Mail Address: Declaration of Disclosure, Page 2 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services 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#: _____________________________________ TO Is 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 Telephone No.: Facsimile No.: E-Mail Address: Declaration of Disclosure, Page 3 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : e. Description Index No. Calendar No. : Personal Property (including appliances, furniture, jewelry, art, guns, etc.) JUDICIAL SUBPOENA Plaintiff(s) -against- : 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 Telephone No.: Facsimile No.: E-Mail Address: Declaration of Disclosure, Page 4 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : f. Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA Business Interests (including equipment, tools, livestock, etc.) -against- : Estimated Value : Description Name(s) on Title : Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK TO g. Other Assets Description Estimated Value Name(s) on Title 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. 2. Disclosure of Debts Witness, Honorable County, Creditor day of Description Court in Secured Debt on Real Property (See 1(a) above) Vehicle Loan(s) (See 1(b) above) Utility Bill(s): , one of the Justices of the , 20 Amount Owed Name on Debt XXXXX XXXXXXXXX (Attorney must sign above and type name below) XXXXX XXXXXXXXX Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Declaration of Disclosure, Page 5 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services 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 [ ]Wife/ [ ]Husband 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.: E-Mail Address: Declaration of Disclosure, Page 6 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Source of Income Child Support Plaintiff(s) -against- : 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 TO 4. Disclosure of Expenses The [ ] Wife/[ ] Husband has the following expenses: GREETINGS: Amount per Month Description of Expense Taxes WE COMMAND YOU, that from income excuses being laid aside, you and each of you attend before and other money withheld all business and , the Honorable at the Court located at County of Retirement in room , on the day of , 20 , at o'clock in the noon, and at any recessed Health Insurance (self and give evidence as a witness in this action on the part of the or adjourned date, to testifyand children) Medical Expenses Housing (rent or mortgage payment)subpoena is punishable as a contempt of court and will make you liable to Your failure to comply with this the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Property Taxes result of your failure to comply. Property Insurance Witness, Honorable County, Transportation Court in , one of the Justices of the day of , 20 Car Insurance Student Loans (Attorney must sign above and type name below) Utilities Telephone Attorney(s) for Clothing Food and Household Supplies Child Care Office and P.O. Address Child Support Payments Telephone No.: Facsimile No.: E-Mail Address: Declaration of Disclosure, Page 7 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services 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 [ ] Wife/ [ ] Husband, Petitioner 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.: E-Mail Address: Declaration of Disclosure, Page 8 of 8 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02 Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com