Custodians Report Form. This is a Oregon form and can be use in Polk Local County.
Tags: Custodians Report, Oregon Local County, Polk
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : IN THE CIRCUIT COURT FOR THE STATE OF OREGONSUBPOENA JUDICIAL Plaintiff(s) FOR THE COUNTY OF POLK -against- : In the Matter of the Protective Proceeding for ) : ) Case No.________________ : ________________________________________ ) ) CUSTODIAN’S REPORT Defendant(s) : A.minor,. Protected.Person.. . . . . . . . . . . . . . . . . . . . . . . ) . . . . .... ..... ........ ...... . I am the custodian of funds for the child named above, and I make the following report to the court: THE PEOPLE OF THE STATE OF NEW YORK 1. TO My name, address and telephone number are:_______________________________________ ___________________________________________________________________________ __________________________________________Phone:______________________________ GREETINGS: 2. The address where the child lives is:______________________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend ___________________________________________________________________________ before , the Honorable at the Court located at County of my last report I have: 3. Since in room a. Been ,convicted ofday of on the , 20 , at o'clock in the noon, “ none. the following crime(s):___________________________/and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the b. Received protection under federal bankruptcy laws: “yes / “ no. c. Had a job-related license revoked or suspended: “ yes / “ no. d. Had my driver’s license revoked or suspended: “ yes / “ no. 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 subpoenaof theissued recent statement of each account that holds the 4. Attached to this report is a copy was most for a maximum penalty of $50 and all damages sustained as a resultchild’s funds . to comply. of your failure Witness, Honorable Court in County, STATE OF OREGON ) ) ss County of Polk ) day of , one of the Justices of the _________________________________________ , 20 Custodian (Attorney must sign above and type name below) I, _____________________________________, (Custodian’s name), being first duly Attorney(s) for sworn, say that the above statements are true. _________________________________________ Office and Custodian P.O. Address Subscribed and sworn to before me on _____day of ______________________, 20____. Telephone No.: _________________________________________ Facsimile No.: Notary Public for Oregon E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com