COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index COUNTY, OHIO COURT OF COMMON PLEAS, GEAUGA No. : Plaintiff(s) STATE OF OHIO -againstCounty of ) ) ss: Calendar No. CASE NO. : JUDICIAL SUBPOENA : AFFIDAVIT : , being sworn, says: : 1. He/she is the plaintiff/defendant in the above-entitled action. Defendant(s) : ...................................................... 2. This is an action for , as to (insert name of , born child) STATE OF NEW YORK THE PEOPLE OF THE 3. TO , _____. This child's present address is 4. This child has lived in the following places and with the following persons within the last five years: (List addresses and dates when child lived there and list person with whom the child lived GREETINGS: this time and that person's present address.) during WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Addresses and Dates Persons and Present Addresses , the Honorable at the Court located at County of At With in room from , on the day of , 20 , at o'clock in the noon, and at any recessed to Presently at or adjourned date, to testify and give evidence as a witness in this action on the part of the At With from to Presently at NOTE: If more space is needed, please attach a separate piece of paper with the additional information. 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 5. He/she result of your failure to comply. has/has not participated as a party, witness, or in any other capacity in any other litigation concerning the custody of this child in this or any other state. Court in Witness, Honorable , one of the Justices of the 6. He/she has/has no information of any custody proceeding concerning this child pending in County, day of , 20 a court of this or any other state. 7. He/she knows/does not know of any person not a party to the proceedings who has (Attorney must sign above with respect to this physical custody of this child or claims to have custody or visitation rights and type name below) child. 8. He/she understands that he/she has a continuing duty to inform the Court of any custody proceeding concerning this child in this or any other state of which he/she obtains information during this Attorney(s) for proceeding. 9. He/she has/has not previously been convicted or or pled guilty to any criminal offense or been determined a perpetrator per R.C. 3109.27(A)(4). Office and P.O. Address (signature) Telephone day of No.: Sworn to before me and subscribed to in my presence this , 20 . Facsimile No.: E-Mail Address: Mobile Tel. No.: (signature and title of officer) American LegalNet, Inc. www.USCourtForms.com