COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : : Plaintiff(s) Calendar No. JUDICIAL SUBPOENA State of New Hampshire -against: Bureau of Securities Regulation : PROFESSIONAL BONDSMEN APPLICATION : 1. FULL NAME, HOME ADDRESS AND BUSINESS OF THE APPLICANT: Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW SECURITY # ___________ DRIVER'S LICENSE # __________ D/O/B ___/___/___ SOCIAL YORK TO 2. NAME OF EMPLOYERS AND ADDRESS: GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 3. PERSONAL FINANCIAL STATEMENT OF THE APPLICANT: , the Honorable at the Court located at County ofANNUAL AND MONTHLY INCOME: 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 $_________ / $_________ PER YEAR APPLICANT $_________/ $_________ PER YEAR APPLICANT'S SPOUSE Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whoseASSETS: subpoena was issued for a maximum penalty of $50 and all damages sustained as a OTHER behalf this result of your failure to comply. Witness, Honorable Court in County, day of MONTHLY EXPENDITURES: , one of the Justices of the , 20 (Attorney must sign above and type name below) 4. PASSPORT PHOTO _________ ATTACHED. Attorney(s) for 5. APPLICANT'S THUMBPRINTS _________ ATTACHED. 6. DESCRIPTION OF ALL ARRESTS AND CONVICTIONS OF THE APPLICANT WHICH HAVE NOT BEEN ANNULLED BY A COURTP.O. Address Office and OF LAW: Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Bureau of Securities Regulation Professional Bondsmen Application Page 2 -against- 7. Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA : DESCRIPTION OF ANY LICENSE ISSUED OR DENIED TO THE APPLICANT BY : THE NEW HAMPSHIRE INSURANCE DEPARTMENT: : Defendant(s) : ...................................................... 8. DESCRIPTION OF ANY LICENSES ISSUED OR DENIED TO THE APPLICANT RELATIVE TO THE BAILBOND BUSINESS BY ANY GOVERNMENT AGENCY: THE PEOPLE OF THE STATE OF NEW YORK TO 9. DESCRIPTION OF APPLICANT'S EXPERIENCE IN LAW ENFORCEMENT OR LAW ENFORCEMENT RELATED OCCUPATION: 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 in10. room A GENERAL POWER of ATTORNEY FROM A SURETY COMPANY WILL BE recessed , on the day OF , 20 , at o'clock in the noon, and at any or adjourned date, to testify and give evidence as a witness in this action on the part of the PROVIDED BY: 11. A FIDELITY BOND WILL BE PROVIDED BY: 12. IF THE APPLICANT IS NOT A RESIDENT OF NEW HAMPSHIRE, THE SECRETARY OF STATE HAS BEEN APPOINTED AS "AGENT" FORone of the JusticesPROCESS. SERVICE OF of the Witness, Honorable , 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. Court in County, day of , 20 THE APPLICANT SHALL BE SUBSCRIBED WITH THE SWORN STATEMENT THAT THE INFORMATION CONTAINED HEREIN IS TRUE. (Attorney must sign above and type name below) ______________________ APPLICANT Attorney(s) for ______________________ DATE Office and P.O. Address SIGNED AND SWORN BEFORE ME TO BE TRUE ______________________ Telephone ______________________ MY COMMISSION EXPIRES No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com