COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. LOCAL BANKRUPTCY FORM NO. 22 : Calendar No. IN THE UNITED STATES BANKRUPTCY COURT : WESTERN DISTRICT OF PENNSYLVANIA JUDICIAL SUBPOENA Plaintiff(s) -against- :Bankruptcy No. : Chapter : Document No. : IN RE Debtor(s) Movant(s) v Respondent(s) : : : Defendant(s) : ...................................................... MOTION TO AVOID LIENS AND NOW comes Debtor(s) avoiding the judicial lien(s) of THE PEOPLE OF Debtor(s) is/are entitled, to-wit,THE STATE OF NEW , Q pro se Q by counsel , , and move(s) to enter the attached order , created on , which impair(s) an exemption to which the YORK , under [here insert statutory section allowing the exemption] . TO 1. Information concerning the lien(s) to be avoided: a. The amount of the lien(s): $ GREETINGS: $ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before $ , the Honorable at the Court b. All other liens of the property, $ located at County on the amount of each lien, and by whom $ in room , on the day of , 20 , at o'clock in the noon, and at any recessed held or adjourned date, to testify and give evidence as a witness in this action on the part of the are (use additional sheets $ if necessary): $ c. The amount of exemption Debtor(s) could claim if there were no liens is: $ 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 2. The total of (a) through (c) above is: $ result of your failure to comply. 3. The value of the Debtor's(s') interest in the property if there were noHonorable be: Witness, liens would Court in County, $ day of 4. The amount of other liens that have been avoided in this case is: , 20 , one of the Justices of the $ 5. Liens not included in the above calculation (specify): (Attorney must sign above and type name below) 6. The lien(s) to be avoided fall under 11 U.S.C. 522(f)(1). Signature of Counsel or Debtor(s) if Attorney(s) pro se for Typed Name Office and P.O. Address Address Telephone No.: Facsimile No.: E-Mail Address: List Bar I.D. and State of AdmissionMobile Tel. No.: Phone No. American LegalNet, Inc. www.USCourtForms.com