COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. FAX COVER SHEET Calendar No. : FOR USE IN NEBRASKA COURTS : JUDICIAL SUBPOENA USE ONLY FOR DOCUMENTS TO BE FILED IN THE COURT FILE -against: Plaintiff(s) : FILINGS: Filings by electronic transmission of a facsimile are governed by "Nebraska Supreme Court Rules for the Use of Fax Machines in State Courts." : Defendant(s) PAGE LIMIT: No single transmission shall exceed ten (10) pages without special permission from the clerk who will : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . in receive the. transmission.. .The .FAX. COVER. SHEET. is. not .counted . . the limit on pages for transmission. FEES: Fees for filing by fax transmission shall be paid in compliance with statutes and the "Nebraska Supreme Court Rules for the Use of Fax Machines in State Courts." THE PEOPLE OF THE STATE OF NEW YORK TO TYPE OR PRINT INFORMATION 1. SENDER'S NAME AND ADDRESS: _________________________________ _________________________________________________________ GREETINGS: _________________________________________________________ N.S.B.A. No. _______________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court 2. SENDER'S TELEPHONE NUMBER: ________________________________ SENDER'S FAX NUMBER: ___________________ located at County of in room , on the day of , 20 , at o'clock in FAX NUMBER: ____________________ noon, and at any recessed 3. RECEIVING COURT: ____________________________________________ COURT'S the or adjourned date, to testify and give evidence as a witness in this action on the part of the 4. CASE CAPTION: _________________________________________________________________________________________ vs. _________________________________________________________________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party____________________subpoena was issued for a maximum penalty of $50 and all damages sustained as a 5. CASE NUMBER: on whose behalf this result of your failure to comply. 6. DOCUMENT TRANSMITTED: A. Nature of Document: _____________________________________________________________________________ Witness, Document: , one of the Justices of the B. Number of Pages in Honorable____________________ C.Court in Total Pages Transmitted (Excluding Cover Sheet): ____________________ County, day of , 20 7. FEES: (No fee for cover page) 1. Statutory filing fee ............................................................................................ $ 2. First page ($3.00) .............................................................................................. (Attorney must sign above and type name below) 3. Additional pages ($1.00 per page) .................................................................... 4. Credit Card Fee ($3.00) .................................................................................... TOTAL FEES: .......................................................................................... $ 8. CREDIT CARD: MasterCard _____ Visa _____ Other _____ Attorney(s) for Account No.: ___________________________________ Expiration Date: _______________ __________________________________________________ (Type or print name of cardholder) Office and P.O. Address ______________________________________________ (Signature of cardholder) Telephone No.: Facsimile No.: APPROVED BY NEBRASKA SUPREME COURT: JANUARY 1993 E-Mail Address: Mobile Tel. No.: -27.4- American LegalNet, Inc. www.USCourtForms.com