COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : : UNITED STATES DISTRICT COURT Plaintiff(s) WESTERN DISTRICT OF NEW YORK -against- Calendar No. JUDICIAL SUBPOENA Form 1 : : , : Plaintiff, Defendant(s) : ...................................................... v. NOTICE OF APPEAL ________-CV-_________ , THE PEOPLE OF THE STATE OF NEW YORK TO Defendant(s). GREETINGS: is hereby giventhat ______________________________________[print your name], Notice WE COMMAND YOU, that all business and excuses being laid aside, you _________________________ [identify yourself as plaintiff or defendant in theand eachcourt action] before district of you attend , the Honorable at the Court located at County of in the above-named the case, hereby appeals to the United States o'clockof the Court in Appealsnoon,the Secondrecessed for and at any in room , on day of , 20 , at or adjourned date, to testify and give evidence as a witness in this action on the part of the Circuit from ________all ________part [ heck one] of the decision of this Court entered on c ________________, 20____. 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 [Complete the next section only if you are not appealing the whole order.] I am appealing result of your failure to comply. from theWitness, Honorable part of the order which ______________________________________________________ , one of the Justices of the Court in County, day of , 20 ______________________________________________________________________________ _________________________________________________________________________________ (Attorney must sign above and type name below) Dated: _________________, 20___ Signature Attorney(s) for Print Your Name Appearing Pro Se Office and P.O. Address Address: _______________________________________ Telephone No.: _______________________________________ Telephone: Facsimile No.: E-Mail Address: _____________________________________ Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com