COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF MONTGOMERY COUNTY, OHIOCalendar No.ALICE O. McCOLLUM, JUDGEJUDICIAL SUBPOENAPlaintiff(s)GUARDIANSHIP OF CASE NO.-against-AFFIDAVIT(R.C. 3109.27)Defendant(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .s.s.State of Ohio, County ofTHE PEOPLE OF THE STATE OF NEW YORK TO(To be filed only when guardianship of the person of a minor is sought.) Affiant being first duly sworn, deposes and says:1. That the child's present address, the places where the child has lived within the last five years, and the names and present addresses of the person(s) with whom the child has lived during that period are: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 room2. That affiant has (not) participated as a party, witness, or in any other capacity in any litigation concerning the custody of the child(ren) in this or any other state. 3. That affiant has (no) information of any custody proceeding concerning the child(ren) pending in a court of this or any other state. 4. That affiant has (no) knowledge of any person not a party to the proceedings who has physical custody of the child(ren) or claims to have custody or visitation rights with respect to the child(ren).If 2, 3, or 4 is answered in the affirmative, and the space afforded is insufficient for full explanation, please attach and incorporate herein any necessary 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 result of your failure to comply., one of the Justices of theCourt in Witness, Honorableday of, 20 County,he has a continuing duty to inform the Court of any custody Affiant realizes that proceedings concerning the child(ren) in this or any other state of which affiant obtains information during the pendency of this proceeding.(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. Addressday of Sworn to before me and subscribed in my presencethis.,Telephone No.: Facsimile No.: E-Mail Address:Notary PublicMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com09/01/91FORM 16.1 -AFFIDAVIT