File No. STATE OF NORTH CAROLINA COURT COUNTY . . . . . . . . . . . .OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IN THE GENERAL COURT OF JUSTICE : Index No. COUNTY OF DISTRICT COURT DIVISION Attorney State Bar No. Plaintiff(s) Address -against- Telephone No. : Calendar No. : JUDICIAL SUBPOENA SECURE LEAVE : FORM : : Rule 26; Rule 33A Rules of Appellate Procedure : Notice:. . Secure. Leave . . . . .consist .of.one. or . .Defendant(s) . . . . . . . but in any event shall not consist of more than . . . . . . . . . . . . . . shall . . . . . . . . . . more. calendared weeks, .. ....... three (3) calendared weeks during any calendar year. STATEMENT OF ATTORNEY THE PEOPLE OF that the secure leave period designated below is not being designated for the purpose of I hereby certify THE STATE OF NEW YORK delaying, hindering or interfering with the timely disposition of any matter in any pending action or TO proceeding. I further certify that no action or proceeding in which I have entered an appearance has been scheduled, peremptorily set or noticed for trial, hearing, deposition or other proceeding during the designated leave GREETINGS: period. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before DESIGNATED SECURE , the Honorable at the Court located at LEAVE DATES County of Beginning of Secured Leavethe in room , on (date) day of , 20 Ending of Secure Leave (date) , 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 Indicate any previously designated Secure Leave periods during the current calendar year that have previously Your failure to comply with this subpoena is punishableof the Rules ofof court and Procedure: liable to been designated pursuant to Rule 26 and Rule 33A as a contempt Appellate will make you the party Secured Leave (date) a maximum penalty (date) Beginning of on whose behalf this subpoena was issued forEnding of Secure Leave of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable , one of the Justices of the This Secured Leave notification must be filed not later than ninety (90) days before the beginning of the secured Court in County, day of , 20 leave period and before any trial, hearing, deposition or other regularly scheduled matter, peremptorily set or noticed for a time during the designated secured leave period. Date Attorney (Attorney must sign above and type name below) This form is required to be filed in each of the following offices if the attorney for entered an appearance of record: Attorney(s) has District Attorney Chief District Court Judge Clerk of Superior Court NOTICE TO ATTORNEY: Should any matter be set during your Secured Leave Period, you are required to serve Office and P.O. Address notice on the official calendaring the matter and the parties of record to the matter. This notice shall contain the following: (1) a copy of this form, (2) the case name and number, and (3) a certificate of service. DC Secured Leave Form District 11-District Court Effective 6/1/04 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com