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Motion For Leave To Proceed On Appeal Without Payment Of Costs Or Fees Form. This is a Official Federal Forms form and can be use in 10th Circuit Court Of Appeals Circuit Court Of Appeals.
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Tags: Motion For Leave To Proceed On Appeal Without Payment Of Costs Or Fees, A-16, Official Federal Forms Circuit Court Of Appeals, 10th Circuit Court Of Appeals
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COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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:
:
Index No.
Calendar No.
UNITED STATES COURT OF: APPEALS
JUDICIAL SUBPOENA
Plaintiff(s)
FOR THE TENTH CIRCUIT
-against-
:
:
:
Case No. __________________
Defendant(s)
:
......................................................
9 Motion for Leave to Proceed on
Plaintiff/Petitioner - Appellant,
Appeal Without Prepayment of
Costs or Fees
(Part A)
THE PEOPLE OF THE STATE OF NEW YORK
v.
9 Application for Certificate of
TO
of Appealability
GREETINGS:
Defendant/Respondent - Appellee.
9 Appellant/Petitioner’s Opening
WE COMMAND YOU, that all business and excuses being laid aside, you and each of youB)
Brief
(Part attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
o'clock in the
noon, and at any recessed
PART A, at
or adjourned date, to testify and give evidence as a witness in this action on the part of the
NOTICE AND INSTRUCTIONS
Your failure to comply to proceed on appeal without a contempt of court and will make you
Your motion for leave with this subpoena is punishable asprepayment of costs or fees and 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.
application for a certificate of appealability will be evaluated by the court using these
Witness, Honorable
Court in
County,
standards:
, one of the Justices of the
day of
, 20
I, _________________________________________, the petitioner/appellant below)
(Attorney must sign above and type name
in the captioned case move this court for leave to proceed in forma pauperis.
Attorney(s) for
In support of this motion, I state that because of my poverty, I am unable to pay the
costs of said proceedings or give security therefor, I submit the attached financial
Office and P.O. Address
declaration.
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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Certificate of Appealability. There must be a substantial showing ofSUBPOENA a
JUDICIAL the denial of
Plaintiff(s)
constitutional right by demonstrating that the issues raised are debatable among jurists,
-against:
that a court could resolve the issues differently, or that the questions deserve further
proceedings. 28 U.S.C. § 2253 (c); Lennox v. Evans, 87 F.3d 431 (10th Cir. 1996).
:
:
FAILURE TO SET FORTH FACTS AND ARGUMENTS SHOWING THAT
YOU MEET THE APPROPRIATE STANDARD WILL SUBJECT YOUR
Defendant(s)
:
. .APPEAL .TO .DISMISSAL. WITHOUT. . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FURTHER NOTICE.
You may use Part A of this form to furnish a statement of the case, the issues you
intend to raise THE STATE OF NEW YORK
THE PEOPLE OF on appeal, and the reasons your appeal meets the applicable standards. The
form is intended to guide you in meeting the above standards. If you need more space to
TO
answer, additional pages may be attached. The information you furnish, together with the
full record of the proceedings in the district court, will be the basis for this court’s
decision. You should bear in mind that an appeal is not a retrial, but rather a review of
the district
GREETINGS: court’s judgment and record of proceedings.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
APPLICATION AND/OR MOTION
,
the Honorable
at the
Court
located at
County of
in1. Statement, of the Case. (This should be a brief summary of thethe
room
on the
day of
, 20
, at
o'clock in proceedingsand the recessed
noon, in at any
district court.) to testify and give evidence as a witness in this action on the part of the
or adjourned date,
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.
Witness, Honorable
one time Justices of
2. Issues to be Raised on Appeal. (New issues raised for the ,first of the on appeal the
Court in
day
, 20
generally will not County,
be considered.) of
(Attorney must sign above and type name below)
Attorney(s) for
3. Summary of Your Argument Showing that Your Appeal Meets the Appropriate
Standards.
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 2
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
4. Do you think the district court applied the wrong law? If so, what law do you
-against:
want applied?
:
:
Defendant(s)
:
......................................................
5. Did the district court incorrectly decide the facts? If so, what facts?
THE PEOPLE OF THE STATE OF NEW YORK
TO
6. Did the district court fail to consider important grounds for relief? If so, what
grounds?
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
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
7. Do you feel that there are any other reasons why the district court’s judgment
was wrong? If so, what?
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.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
8. What action do you w ant this court to take in your case?
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 3
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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9. Were you required to seek and Plaintiff(s)administrative remedies prior to filing
exhaust
JUDICIAL SUBPOENA
your claim in district court? If yes, what steps did you take to exhaust those
-against:
remedies?
:
:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
_________________________
GREETINGS:
Date
___________________________________
Signature
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
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
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.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 4
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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FINANCIAL DECLARATION
JUDICIAL SUBPOENA
Plaintiff(s)
-against-
:
:
Affidavit in Support of Motion to Proceed on Appeal in Forma Pauperis
:
Defendant(s)
:
......................................................
I swear or affirm under penalty of perjury that because of my poverty I am unable to pay the
docket fees of my appeal or to post a bond for them. I believe I am entitled to a different result
than that reached in the district court.
THE PEOPLE OF THE STATE OF NEW YORK
I further swear or affirm under penalty of perjury that the responses which I have made to the
questions and instructions below relating to my ability to pay the fees for my appeal are true.
TO
Instructions. Please complete all questions in this application and then sign it on the last
page. If the
GREETINGS: answer to any question is "0" or "none," or the question is "not applicable", so
indicate by writing "0", "none", or "not applicable (N/A)". If additional space is needed to
answer WE COMMANDto explain your answer to any question, laid aside, you and eachaof you attend before
any question or YOU, that all business and excuses being please use and attach separate
,
the Honorable identified with your name, the docket number of your case and the number of the
at the
Court
sheet of paper
located at
County of
question.
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or1. Are you or your spouse currently employed?
adjourned date, to testify and give evidence as a witness in this action on the part of the
Yes _____ No _____
2. If you or your spouse are currently employed, state the name and address of your employer,
the lengthfailure to employment this subpoena is punishable as a monthly gross pay. Gross pay is liable to
Your of your comply with with that employer, and your contempt of court and will make you
the pay before any behalf or other deductions are taken. maximum penalty of $50one employer, sustained as a
party on whose taxes this subpoena was issued for a If you have more than and all damages
result of your failure to information requested below about the other employer(s) on a separate
please provide the comply.
sheet of paper and attach it to this application.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 5
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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Plaintiff(s)
Yourself:
Calendar No.
:
JUDICIAL SUBPOENA
Your Spouse: :
-against-
Name and Address of Employer
Name and Address of Employer
:
_________________________________ _________________________________
:
_________________________________ _________________________________
Defendant(s)
_________________________________ _________________________________
:
......................................................
Length of Employment
_____ ______
Years Months
Length of Employment
_____ ______
THE PEOPLE OF THE STATE OF NEW YORK
Years Months
TO
Monthly Gross Pay $____________
Monthly Gross Pay $____________
3. If you are
GREETINGS: currently unemployed, state the date of your last employment and your monthly
gross pay during your last month of employment. Gross pay is pay before any taxes or other
deductions are taken. YOU, that all business and excuses being laid aside, you and each of you attend before
WE COMMAND
,
the Honorable
at the
Court
Date of
located at
County of last employment (Month/Year) for yourself _______________; spouse _____________
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
orMonthly gross pay during last month of employment in this action on the part of the
adjourned date, to testify and give evidence as a witness $____________
4. State whether you or your spouse have received money from any of the following sources
during the failure to comply with and,subpoena is punishable as a contempt from that source.
Your past twelve months, this if so, the average monthly amount of court and will make you liable to
Adjust any money that was received weekly, bi-weekly, quarterly, semi-annually, or annually
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
to of your failure to comply.
result show the monthly rate.
Did you receive money from
any of Witness, Honorable
the following sources
Court in the past 12 County,
during
months?
day of
Amount expected next
Average monthly amount during
, one of the Justices of the
month
past 12 months for you and your
20
spouse if, applicable.
You
Spouse
You
Spouse
Self-employment
Y/N ___
(Attorney $ _______ $ _______ $
$ _______ must sign above and type name below)_______
Income from real property
(such as rental income)
Y/N ___
$ _______ $ _______
Attorney(s) for
$ _______
$ _______
Interest and dividends
Y/N ___
$ _______
$ _______
$ _______
$ _______
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 6
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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Plaintiff(s) $ _______
Y/N ___
Gifts
-against-
Index No.
Calendar No.
JUDICIAL _______ $ _______
$ _______ $SUBPOENA
Y/N ___
:
$ _______
$ _______
$ _______
$ _______
Y/N ___
:
$ _______
$ _______
$ _______
$ _______
Retirement income from sources
:
such as social security, private
Defendant(s)
pensions, annuities, or insurance
:
......................................................
policies
Y/N ___ $ _______
$ _______
$ _______
$ _______
Disability payments such as social
security, other state or federal
THE PEOPLE OF THE STATE OF NEW YORK
government, or insurance payments Y/N ___
$ _______
$ _______
$ _______
$ _______
TO
Y/N ___
$ _______
$ _______
$ _______
$ _______
Public assistance payments such as
welfare payments
Y/N ___
$ _______
$ _______
$ _______
$ _______
Alimony
Child Support
Unemployment payments
GREETINGS:
Other sources of money
(specify: ____________________) Y/N and excuses being laid aside, you and _______ $ _______
WE COMMAND YOU, that all business ___ $ _______ $ _______ $ each of you attend before
,
the Honorable
at the
Court
located at
County of
TOTAL
$ _______ $ _______ $ _______
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
5. State the amount of cash you and your spouse have: $ ___________
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.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 7
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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State below any money you or your spouse have in savings, :checking, or other accounts in a bank
JUDICIAL SUBPOENA
Plaintiff(s)
or other financial institution.
-against-
Bank or Other Financial Institution:
:
:
Type of Account
such as savings,
:
checking, or CD:
Defendant(s)
__________________________________ ________________
:
......................................................
Amount you
have:
Amount your
spouse has:
$ _________
$ _________
__________________________________
________________
$ _________
$ _________
__________________________________
________________
$ _________
$ _________
THE PEOPLE OF THE STATE OF NEW YORK
TO
6. State below the assets owned by you and your spouse. Do not list ordinary household
furnishings and clothing.
GREETINGS:
laid aside, you and each
Address:
Home WE COMMAND YOU, that all business and excuses being Value: $ _________ of you attend before
,
the Honorable
at the
Court
_________________________________ Amount owed on mortgages and
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
_________________________________ liens: $ part of the
or adjourned date, to testify and give evidence as a witness in this action on the_________
Other real
Address:
Value: $ _________
estate
_________________________________
Amount owed on mortgages and
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
_________________________________ penalty _________
the party on whose behalf this subpoena was issued for a maximum liens: $ of $50 and all damages sustained as a
result of your failure to comply.
Motor vehicle
Model/Year:
Value: $ _________
________________________
Witness, Honorable
Court in vehicle Model/Year: day of
County,
, 20
Motor
Amount owed: $ _________
, one of the Justices of the
Value: $ _________
________________________
Other
Amount owed: $ _________
(Attorney must $ ________
Description: ______________________ Value:sign above and type name below)
_________________________________
Amount owed: $ _________
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 8
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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7. State below any person, business, organization, or governmental unit that owes you or your
JUDICIAL SUBPOENA
Plaintiff(s)
spouse money and the amount that is owed.
-against-
:
Name of Person, Business, or Organization Amount Owed
:
Amount Owed
that Owes You or Your Spouse Money
You:
Your Spouse:
__________________________________
$ _________ :
$ _________
Defendant(s)
__________________________________ $ _________ :
......................................................
$ _________
8. State the individuals who rely on you and your spouse for support. Indicate their relationship
THEto you, their age, and whether NEWlive with you.
PEOPLE OF THE STATE OF they YORK
TO
Name
Relationship
Age
Does this person live with
you?
___________________
________________
_________
Yes _____
No _____
GREETINGS:
WE COMMAND
___________________YOU, that all business and excuses being laid aside, _____ each of you attend before
________________ _________
Yes you and No _____
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
________________ _________
or ___________________and give evidence as a witness in this action on Yespart of the No _____
adjourned date, to testify
the _____
___________________
________________
_________
Yes _____
No _____
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.
9. Complete this question by estimating the average monthly expensesone you and your family.
Witness, Honorable
, of of the Justices of the
Show
the amounts paidof your spouse. Adjust any payments that are made
Court in separatelyCounty,
day by
, 20
weekly, bi-weekly, quarterly, semi-annually, or annually to show the monthly rate.
You
Spouse
(Attorney must sign above and type name below)
Rent or home mortgage payment (include lot rented for mobile
$ ________
$ ________
home)
Are real estate taxes included? Yes ____ No ____
Attorney(s) for
Is property insurance included? Yes ____ No ____
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 9
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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Utilities: Electricity and heating fuel Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
$ ________
$ ________
-againstWater and sewer
:
$ ________
$ ________
Telephone
:
$ ________
$ ________
:
$ ________
$ ________
Home maintenance (Repairs and upkeep)
Defendant(s)
$ ________
$ ________
Food
$ ________
$ ________
Clothing
$ ________
$ ________
THE PEOPLE OF THE STATE OF NEW YORK
Laundry and dry cleaning
$ ________
$ ________
Medical and dental expenses
TO
$ ________
$ ________
$ ________
$ ________
Recreation, clubs and entertainment, newspapers, magazines, etc. $ ________
$ ________
Other ___________________
:
......................................................
Transportation (not including car payments)
GREETINGS:
Charitable contributions
$ ________
$ ________
WE COMMAND YOU,
Insurance (not deducted fromthat all business and excuses being laid aside, you and each of you attend before
wages or included in home
,
the Honorable
at the
Court
located at
County of payments)
mortgage
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
Homeowner's or renter's
or adjourned date, to testify and give evidence as a witness in this action on $ ________
the part of the $ ________
Life
$ ________
$ ________
Health
$ ________
$ ________
Other ___________________
$ ________
$ ________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
Auto
$ ________
$ ________
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.
Witness, Honorable
Taxes (not deducted from wages or included in home mortgage
Court in
County,
day of
, one of the Justices of the
, 20
payments) (specify) __________________________________
$ ________
Installment payments
(Attorney must sign above and type name below)
$ ________
$ ________
$ ________
$ ________
Attorney(s) for
$ ________
Department Store: (name) ________________________
$ ________
Other ___________________
$ ________
Auto:
Credit Card: (name) ____________________
$ ________
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 10
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
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Other ___________________ Plaintiff(s)
Alimony, maintenance,-againstand support paid to others
Calendar No.
:
JUDICIAL SUBPOENA
$ ________
$ ________
:
$ ________
$ ________
$ ________
$ ________
(attach detailed statement)
$ ________
$ ________
Other ___________________
$ ________
$ ________
$ ________
$ ________
Payments for support of additional dependents not living at: your
home
:
Regular expenses from operation of business, profession, or farm
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TOTAL MONTHLY EXPENSES
TO
10. Do you expect any major changes to your monthly income or expenses during the next four
GREETINGS:
months? Yes _____
No _____
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
If yes, describe.
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or11. Have you paid an attorney any money for witness inin connection the part of case, including the
adjourned date, to testify and give evidence as a services this action on with this the
completion of this form? Yes _____
No _____
If yes, how much? $ _________
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.
If yes, provide the name, address, and telephone number of the attorney:
____________________________________________________________________
Witness, Honorable
, one of the Justices of the
Court in ____________________________________________________________________
County,
day of
, 20
____________________________________________________________________
(Attorney must sign above and type name below)
Have you promised to pay or do you anticipate paying an attorney any money for services in
Attorney(s) for
connection with this case, including the completion of this form? Yes _____
No _____
If yes, how much? $ _________
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 11
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
:
If yes, provide the name, address, and telephone number of the attorney:
JUDICIAL SUBPOENA
Plaintiff(s)
____________________________________________________________________
-against:
____________________________________________________________________
:
____________________________________________________________________
:
Defendant(s)
:
. .12.. .Have .you . . . . .anyone . . . . . . . . . .an. attorney .(such. as a .paralegal, typing service, or another
. . . . . . . . . paid . . . . . . other than . . . . . . . . . . . . . . .
person) any money for services in connection with this case, including the completion of this
form? Yes _____
No _____
THE PEOPLE OF THE STATE OF NEW YORK
If yes, how much? $ _________
TO
If yes, provide the name, address, and telephone number of the person or service:
____________________________________________________________________
GREETINGS:
____________________________________________________________________
____________________________________________________________________ attend before
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you
,
the Honorable
at the
Court
located at
County of
in13. Have you promised to pay or do you anticipate paying anyone other than an attorney (such recessed
room
, 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
as a paralegal, typing service, or another person) any money for services in connection with
this case, including the completion of this form? Yes _____
No _____
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
If yes, how much? $ __________
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
If failure to comply.
result of youryes, provide the name, address, and telephone number of the person or service:
____________________________________________________________________
Witness, Honorable
, one of the Justices of the
Court in ____________________________________________________________________
County,
day of
, 20
____________________________________________________________________
(Attorney must sign above and type name below)
14. How much can you pay each month toward the docket fee for your appeal.
$ ______________
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 12
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
:
15. Please provide any other information that helps to explain why you are unable to pay the
JUDICIAL SUBPOENA
Plaintiff(s)
docket fees for your appeal.
-against-
:
:
:
Defendant(s)
:
......................................................
16. State the address of your legal residence:
___________________________________________________
THE PEOPLE OF THE STATE OF NEW YORK
___________________________________________________
___________________________________________________
TO
Your daytime phone number:
GREETINGS:
(______)___________________
WE COMMAND YOU, that
Your age: __________________ all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
Years
located at
County ofof schooling: _____________________
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or Your social security number: evidence as a witness in this action on the part of the
adjourned date, to testify and give
________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
I party on whose behalf this subpoena was issued for a maximum penalty of $50 and UNITED
the DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THEall damages sustained as a
result of your failure to comply.
STATES OF AMERICA THAT THE FOREGOING IS TRUE AND CORRECT. 28 U.S.C. §
1746, 18 U.S.C. Honorable
Witness, § 1621.
Court in
County,
Date:
, one of the Justices of the
day of
, 20
Signature:
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 13
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
PART
Plaintiff(s) B
Calendar No.
:
JUDICIAL SUBPOENA
-againstNOTICE AND INSTRUCTIONS
:
:
The court will accept a properly completed Part B of Form A-11 in lieu of a
:
formal brief. This form is intended to guide you in presenting your appellate issues and
Defendant(s)
:
arguments to the court. If you need more space, additional pages may be attached. A
......................................................
short statement of each issue presented for review should precede your argument.
Citations to legal authority may also be included. This brief should fully set forth all of the
arguments that you wish the court to consider in connection with this case.
THE PEOPLE OF THE STATE OF NEW YORK
New issues raised for the first time on appeal generally will not be
considered. An appeal is not a retrial but rather a review of the proceedings in the district
court. A copy of the completed form must be served on all opposing counsel and on all
unrepresented parties and a proper certificate of service furnished to this court. A form
GREETINGS:
certificate is attached.
TO
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
APPELLANT/PETITIONER’S OPENING BRIEF
located at
County of
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
1.
Statement of the Case. (This should be a brief summary of the
proceedings in the district court.)
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.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 14
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
2.
Index No.
Calendar No.
:
Statement of Facts Relevant to the Issues Presented for Review.
JUDICIAL SUBPOENA
Plaintiff(s)
-against-
:
:
:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
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
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
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.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 15
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
3.
Statement of Issues.
Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
-against-
:
a. First Issue:
:
:
Argument and Authorities:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
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
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
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
b. Second Issue:
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.
Witness, Honorable and Authorities:
Argument
Court in
County,
day of
, one of the Justices of the
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 16
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
4.
Index No.
Calendar No.
:
Do you think the court should hear oral argument in this case? IfSUBPOENA
JUDICIAL so, why?
Plaintiff(s)
-against-
:
:
:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
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
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
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.
Witness, Honorable
Court in
County,
_____________________
Date
, one of the Justices of the
day of
, 20
___________________________________
Signature
(Attorney must sign above and type name below)
Attorney(s) for
Please note: If the brief exceeds 30 pages, a certificate of compliance must accompany
brief. See Fed. R. App. P. 32.7(a)(7)(C)
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 17
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
:
CERTIFICATE OF SERVICE
JUDICIAL SUBPOENA
Plaintiff(s)
-against-
:
I hereby certify that on _____________________ I mailed a copy of
(date)
:
the:
(check applicable boxes)
:
9
Motion for Leave to Proceed on Appeal Without
9
Application for Certifiate of Appealability
Defendant(s)
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . of . Costs. or. Fees
Prepayment . . . . . . . . .
THE PEOPLE OF THE STATE OF NEW YORK
TO
9
Appellant/Petitioner’s Opening Brief
to ____________________________________, at___________________________,
GREETINGS:
the last known address, by United States mail or courier.
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
Date
Signature
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
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.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
A-16 Motion for Leave to Proceed on Appeal without Prepayment of Costs or Fees, Application for
Certificate of Appealability (Part A), Appellant/Petitioner’s Opening Brief (Part B) NON-PLRA- 4/00
Telephone No.:
Page 18
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
