COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Application by Tenant to Deposit Rent with the Clerk:::::::Index No.Calendar No.No.VANDALIA MUNICIPAL COURT 245 James Bohanan Memorial Drive TO THE CLERK OF COURTJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Vandalia, Ohio 45377NAME AND ADDRESS OF TENANT:NAME AND ADDRESS OF LANDLORD OR AGENT (Street No. & Apt. No.)(Street No. & Apt. No.) Ohio. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., Ohio (City-Village)(Zip)(City-Village)(Zip) In accordance with Section 5321.07, paragraph (1) of the Ohio Revised Code, I hereby make application to deposit all rent that is due and hereafter becomes due the landlord, with the Clerk of the captioned Court.THE PEOPLE OF THE STATE OF NEW YORK TODateSignedINFORMATION IN SUPPORT OF APPLICATION: The undersigned says the following facts are true to the best of his /her knowledge: Notice was given in writing to landlord as prescribed in Section 5321.07, paragraph (A). (Copy of this notice attached hereto.) Service was made on landlord as follows: That payment of my rent due under the rental agreement is current and that my rent is due , in the amount of $ 1. APPLICANT STATES UNDER THE PENALTIES OF PERJURY AND FALSIFICATION THAT THE ABOVE INFORMATION AND APPLICATION HAS BEEN READ AND IS BELIEVED TO BE TRUE.GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour 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., one of the Justices of theCourt in Witness, Honorableday of, 20 County,Signed1. Insert, if applicable: Landlord did NOT supply him with notice in writing that he was a party to any rental agreement which covered three or fewer dwelling units. (Section 5321.07, paragraph (3)(C),ORC. (Attorney must sign above and type name below)Notice to Landlord or Agent Sec. 5321.08 R.C.Attorney(s) forPlease be advised that the above applicant has this date deposited a rental payment with this Court under the provisions of Section 5321.07 R.C. Said deposit has been placed in the Escrow Rental Account and may be released to you upon your application and satisfaction of the provisions of Section 5321.09 R.C. Date,20Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:ClerkMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com