COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.IN THE COURT OF COMMON PLEASRevised 3/22/01 DIVISION OF DOMESTIC RELATIONS MAHONING COUNTY, OHIOCalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s))Case No. ) )JUDGE BETH A. SMITH SSN: ) DOB: ) EMPLOYER: ))PRE-TRIAL STATEMENT PLAINTIFF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .) )OF ) VS.) ) THE PEOPLE OF THE STATE OF NEW YORK TO) ) ) SSN:) DOB:) EMPLOYER :GREETINGS:)) DEFENDANTWE 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 ofThe parties and counsel are under a continuing duty to update this form if any additional information becomes available. If more space is needed, attach extra pages.o'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 room1. ALLOCATION OF PARENTAL RIGHTS AND RESPONSIBILITIESA. Are there any issues with respect to the following: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.1)Paternity( ) Yes( ) No2)Residential Parent( ) Yes( ) No, one of the Justices of the3)Parenting Time( ) Yes( ) NoCourt in Witness, Honorableday of, 20 County,4)Income Tax Exemption( ) No( ) YesB. Are any of the following necessary ?(Attorney must sign above and type name below)1)Mediation( ) No( ) Yes2)Guardian Ad Litem( ) No( ) YesAttorney(s) for3)Psychological Evaluations( ) No( ) Yes4)Other( ) No( ) YesIf so, explain: .Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:1American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.2. SEPARATE PROPERTY PURSUANT TO R.C. 3105.171(A) (6) (a) (i-vii) (Inheritance, property owned before marriage, passive income and appreciation from separate property, property acquired after a decree of legal separation, property excluded by prenuptial agreement, personal injury compensation (except loss of marital earnings and expenses paid from marital assets), gifts made solely to one spouse, etc.)Calendar No.( ) If none, check here.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Describe AssetBasis of ClaimDate Acquired Value of Claim$$$. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3. REAL ESTATE (Includes all interest in real estate, including land contracts, life tenancies, options, cemetery lots, etc.)( ) If none, check here.THE PEOPLE OF THE STATE OF NEW YORK TOAddress of PropertyTitled toPresentMortgage(s)Net Value (H, W, JT)ValueBalance $$$$$$$$$GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable4. VEHICLES (Include automobiles, motorcycles, campers, boats, motor homes, etc.)( ) If none, check here. Year/Make/Model,TitledPresentLoanNet (H ,W, JT)located at County ofValueValue Obligationo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room$ $ $$ $ $$ $ $$ $ $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 $50 and all damages sustained as a result of your failure to comply.$ $ $, one of the Justices of the5. FINANCIAL ACCOUNTS (Include joint and survivorship accounts, POD accounts, checking, savings, money market, certificates of deposit, credit union, mutual funds, etc.)( ) If none, check here.Court in Witness, Honorableday of, 20 County,Institution NameOwnerPresent Balance (H, W, JT)Type ofAccount $(Attorney must sign above and type name below) $ $ $ $Attorney(s) forOffice and P.O. AddressSafety Deposit Box with BankContents: Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:2American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.6. PENSION, PROFIT-SHARING, RETIREMENT PLANS (List all retirement benefits, including pensions, profit sharing plans, 401(K)s, ESOPs, IRAs and deferred compensation.) If there are loans against the plan, attach documentation.Calendar No.( ) If none, check hereJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)TypeOwnedDescriptionYears in PlanValue as of (H, W)(month/day/year) $ $ 7. STOCKS, BONDS, SECURITIES (Include all stocks, bonds, options, savings bonds, all other securities.) Estimate market value if not publicly traded. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .( ) If none, check here.Company NameOwnerNumber of Shares/DescriptionPresent Value (H, W, JT) THE PEOPLE OF THE STATE OF NEW YORK TO$$$GREETINGS:8. LIFE INSURANCE (Include insurance provided by employer, indicate "T" for "term", "WL" for "whole life")WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable( ) If none, check here.,located at County ofCompany NameInsured byTypeFace ValueLoan Balance Cash Surrender Value (H, W, JT) o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room $ $ $ $ $ $ $ $ $ $ $ $Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply., one of the Justices of the9. BUSINESS AND PROFESSIONAL INTERESTS (Include whether individual proprietorship, corporation, unincorporated business, partnership, etc.)( ) If none, check here.Court in Witness, Honorableday of, 20 County,Business Name/InterestOwnerValue (H, W, JT.) Description(Attorney must sign above and type name below)$$Attorney(s