COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. IN THE CIRCUIT COURT OF THE STATE OF OREGON : Calendar No. FOR THE COUNTY OF TILLAMOOK Plaintiff(s) : JUDICIAL SUBPOENA -against- ) Case No.: : Plaintiff ) : ) JUDGMENT, MOT ION, AFFIDAVIT AND ORDER vs ) DEFERRING FEES : ) Defendant Defendant(s) ) : ...................................................... Based on the following affidavit, plaintiff/defendant moves the Court for an order deferring fees in the above-captioned proceeding. THE PEOPLE OF THE STATE OF NEW YORK STATE OF OREGON TO County of Tillamook . Plaintiff / Defendant / Attorney ) ) SS I, , having been duly sworn, upon oath hereby depose and say: I am a litigant in the above-entitled matter, and I have insufficient GREETINGS: income and resources to pay the fees required in this case. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court My financial condition is as follows: located at County of room , on the day of , 20 , at o'clock in the noon, and at any recessed A. in Income or adjourned date, to testify and give evidence as a witness in this action on the part of the 1. Gross Income from employment $ Take-home pay $ YourIncometo comply with this subpoena is punishable as a contempt of court and will make you liable to failure from other sources: 2. 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. $ Witness, Honorable , one of the Justices of the $ Court in County, day of , 20 Total Monthly Income $ On this income I support myself and B. dependents. must sign above and type name below) (Attorney Assets 1. Cash on hand 2. Bank account(s) 3. 4. Car $ Other personal property of commercial valueOffice and P.O. Address (Excluding clothing and household goods) Attorney(s) for $ a. b. $ $ Telephone No.: Facsimile No.: E-Mail Address: Total Assets Mobile Tel. No.: $ $ American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. I own no real property and no other personal property of commercial value. : JUDICIAL SUBPOENA Plaintiff(s) C. Monthly Living Expenses 1. Rent $ -against: 2. Utilities $ : 3. 4. Food stamps : Other a. Defendant(s) : . . . . . . .b.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ $ $ c. $ THE PEOPLE OF THE STATE OF NEW YORK Total Monthly Living Expenses D. TO Debts and Liabilities Creditor $ Balance Due 1. Payment $ $ GREETINGS: 2. $ $ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 3. $ , the Honorable at the Court Total Debts and Liabilities $ located at County of in room , on the day of , 20 , at o'clock in the Total Monthly Expenses $noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the The information contained herein is true and accurate to the best of my knowledge and belief. 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 forPlaintiff / Defendantof Attorneyall damages sustained as a a maximum penalty / $50 and result of your failure to comply. Subscribed and sworn to before me this day of , 20 Witness, Honorable Court JUDGMENT: County, MONEY in , one of the Justices of the day of , 20 Deputy Clerk / Notary The State of Oregon shall have judgment aga inst for deferred fees(Attorney must sign above and type name below) and costs. in the sum of $ IT IS SO ORDERED this day of , 20 Attorney(s) for Judge Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com