COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Calendar No. , Petitioner, : COUNTY, NEBRASKA JUDICIAL SUBPOENA : IN THE DISTRICT COURT OF Plaintiff(s) -against- Index No. Case No. : APPLICATION FOR vs. : CANCELLATION OF PROTECTION ORDER AND Defendant(s) : ,. . . . . . . . . . . . . . . .DISMISSAL OF PETITION ...................................... Respondent. STATE OF NEBRASKA THE PEOPLE OF THE STATE OF NEW) YORK ) ss. ) COUNTY OF TO The petitioner, being first duly sworn, says that: GREETINGS: the petitioner who previously filed a petition for a protection order in the above 1. I am case. I now ask that any protection order previously entered be canceled and/or that WE petition be dismissed all business and excuses being laid aside, you and each of you attend before my COMMAND YOU, that without prejudice. , the Honorable at the Court located at County of 2. A substantial and material change of circumstances has occurred since I last in room , on the day of , 20 , at o'clock in the noon, and at any recessed appeared which justifies my request, consisting action on the part of the or adjourned date, to testify and give evidence as a witness in thisof the following specific facts: 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 (Attach additional page(s) result of your failure to comply. if necessary) 3. Court in Check one: Witness, Honorable waived, taxed to the other party, or have been fullyone of the Justices of the , paid. ___ The costs were ___ I canCounty,costs, but I need 90 days to , 20 the costs. pay the pay day of ___ I request a hearing to show that the allegations were not false and were made in good faith. Dated: _____________, 20____. ___________________________________ (Attorney must sign above and type name below) Petitioner SUBSCRIBED AND SWORN TO before Attorney(s) for me on ______________________. ___________________________________ Clerk of District Court/Notary Public NOTICE OF HEARING AND CERTIFICATE OF SERVICE Office and P.O. Address A hearing will be held on the above applic a t i o n o n at .m. in the District Courtroom, County Courthouse, , Nebraska. Failure of petitioner to appear may result in denial of the application. Telephone No.: I certify that a copy of this application and notice of hearing was mailed to all parties and any Facsimile No.: attorneys of record for any party. E-Mail Address: _ _ _ _ _ _ _ _ _ _Mobile_Tel. No.:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _____ ______ Clerk of District Court (Deputy) American LegalNet, Inc. www.USCourtForms.com