COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. AFFIRMATION OF SERVICE Revised 05/01 WDNY : (If you are not having your signature notarized, useCalendar No. this form) UNITED STATES DISTRICT COURT Plaintiff(s) WESTERN DISTRICT-against- YORK OF NEW : JUDICIAL SUBPOENA : : : , Defendant(s) : ...................................................... Plaintiff(s), AFFIRMATION OF SERVICE v. ________-CV-__________ THE PEOPLE OF THE STATE OF NEW YORK , TO Defendant(s). GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable name) at the Court I, (print your , served a copy of the attached papers located at County of (state the name of your papers) 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 upon all other parties in this case Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to by mailing by hand-delivering the party on whose behalf this subpoena was issued for a maximum penalty of (check the damages sustained as a $50 and all method you result of your failure to comply. used) these documents to the following persons (list the names and addresses of the people you Witness, Honorable , one of the Justices of the served) Court in County, day of , 20 (Attorney must sign above and type name below) Attorney(s) for on (date service was made) Office and P.O. Address I declare under penalty of perjury that the foregoing is true and correct, to the best of my knowledge, information and belief. Executed on (date) Telephone No.: Facsimile No.: E-Mail Address: signature) (your Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com