COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.IN THE COURT OF COMMON PLEAS OF BUCKS COUNTY, PENNSYLVANIA CRIMINAL DIVISIONCalendar No.CLERK OF COURTSJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)COMMONWEALTH OF PENNSYLVANIACASE NO.: VSASSIGNMENT OF BAILTO THE CLERK OF COURTS CRIMINAL DIVISION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .For value received, and intending to be legally bound, the undersigned surety in the above captioned matter(hereinafter called Assignor ) does hereby assign to (hereinafter called Assignee ) the sum of $ which has been deposited by the Assignor and is being held by you as security in the above-captioned case or cases.THE PEOPLE OF THE STATE OF NEW YORK TOThis Assignment is deemed to be irrevocable and unless rescinded by mutual consent of the Assignor andAssignee, in writing, duly acknowledged and filed in the Office of the Clerk of Courts, no further assignment or re-assignment of the security shall be made and/or be honored by the Office of Clerk of Courts.GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableThe undersigned Assignor and the Assignee, release you from any and all obligation, responsibility and liability,located at County offor any disbursements made of the security or any part thereof to the Assignee on as otherwise authorized by this Assignment.o'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 roomIn witness whereof, the undersigned has hereunto set his/her hand and seal this day of , 20.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. AssignorAssigneeCOMMONWEALTH OF PENNSYLVANIA:Address of Assignee COUNTY OF BUCKS, one of the Justices of theCourt in Witness, Honorableday of, 20 County,On this, the day of , 20, before me a Notary Public, personally appeared Assignor, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing Assignment and acknowledged that he executed the same freely and for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal.(Attorney must sign above and type name below)Attorney(s) forNotary PublicOffice and P.O. AddressNote: Bail Assignments must be filed in the Clerk of Courts Office prior to commencement of Trial. The Clerk of Courts' Office will not accept any Bail Assignments after the commencement of Trial.Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com