COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.CIVIL CASE INFORMATION MONTGOMERY COUNTY COMMON PLEAS COURT GENERAL DIVISION Room 5, 41 North Perry Street, Dayton, OH 45422JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)This form must be completed and filed with all civil suits.Main PlaintiffCase Number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Main Counsel for PlaintiffAttorney Registration NumberTHE PEOPLE OF THE STATE OF NEW YORK TOMain Counsel for Defendant (If known)Main DefendantJury Demanded: YesDeposit Amt:NoPrayer Amt:Type of Action (Select Only One)GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableOT -Administrative Appeal,-Other Torts PIPL PTWCAOlocated at County of-Appropriation -Declaratory Judgment -Forcible Entry -Habeas Corpus -Injunction -Medical Malpractice -Mortgage Foreclosureo'clock in the day ofnoon, and at any recessed in room, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of the-Personal Injury -Product Liability -Professional Tort -Worker's Compensation -All Others -State TypeAA ADJFEHC IMM MFYour 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.Refiling Information, one of the Justices of theCourt in Witness, Honorableday of, 20 County,NoIs this a refiling of a previous related case? YesPrevious Case Number:If Yes, please complete the following:vs(Attorney must sign above and type name below)Party (2)Party (1)Assigned JudgeSuits Involving Like Issues and Similar PartiesAttorney(s) forNoYesAre there any other cases pending that arise from the same incident or related parties?Previous Case Number:If Yes, please complete the following:vsOffice and P.O. AddressParty (1)Assigned JudgeParty (2)Telephone No.: Facsimile No.: E-Mail Address:Date Signature of Attorney or Party Filing SuitMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com