COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... Notice to Butler County Auditor Application for Unclaimed Funds THE PEOPLE OF THE STATE OF NEW YORK TO Case # Plaintiff: GREETINGS: Defendant: The unclaimed funds held business and excuses being laid aside, you and each of to be released. WE COMMAND YOU, that all in the above mentioned court case are hereby requested you attend before , the Honorable The records of the Butler County Clerk of Courts reflect that the applicant is entitled to receive at the Court these funds. located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Please mail check directly to: as a witness in this action on the part of the or adjourned date, to testify and give evidence Applicant’s Name: Applicant’s Address: 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, day of , $ Amount of Unclaimed funds requested:20 , one of the Justices of the Driver’s License # (Attorney must sign above and type name below) Applicant’s Signature: Date: Attorney(s) for Finance Department Use only Date of pay-in: Pay in #: Office this case and is entitled to receive the I certify the applicant is the true and authorized party toand P.O. Address funds requested. Date Telephone No.: Authorized Finance Department Representative Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com