COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : IN THE DISTRICT COURT OF Calendar No. COUNTY, NEBRASKA Plaintiff(s) , -against- Index No. : : Petitioner, JUDICIAL SUBPOENA Case No. APPLICATION FOR MODIFICATION OF : PROTECTION ORDER : vs. , Defendant(s) : . . . . . . . . . . . . . . . . . . . . . Respondent. . . . . . . . . . . . . . . . . . . . . . ............ STATE OF NEBRASKA THE PEOPLE OF THE STATE OF COUNTY OF ) ss. NEW) YORK ) TO The undersigned, being first duly sworn, says that: 1. I am the petitioner or respondent in the above matter. I now ask that the protection GREETINGS: previously entered be modified to order 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 ofA substantial and material change of circumstances has occurred since I last 2. in room appeared which justifies my request, 20 , on the day of , consisting of the following specific facts: at any recessed , at o'clock in the noon, and 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 (Attach additional page(s) if necessary) result of your failure to comply. 3. Court in Check one: ___ The costs were Witness, Honorable waived, taxed to the other party, or have been fullyone of the Justices of the , paid. ___ I can pay the costs, but I need 90 days to pay the costs. County, day of , 20 ___ 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/Respondent SUBSCRIBED AND SWORN TO before me on ______________________. ___________________________________ Attorney(s) for 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 application on at .m. in the District Courtroom, County Courthouse, , Nebraska. Failure of moving party 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 attorneys of record for any party. Facsimile No.: E-Mail Address: __________________________________________ Mobile Tel. No.: Clerk of District Court (Deputy) American LegalNet, Inc. www.USCourtForms.com