COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : STATE OF SOUTH CAROLINA ) ) COUNTY OF _______________ ) -against- Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) MANUFACTURED HOME LIEN AFFIDAVIT : : (1) Name of Owner:_________________________________ (2) Description of Manufactured Home: : Date of Manufacture: _______________ Manufacturer:_______________________ Defendant(s) : . . . . . Model. year: _________________. Make:_____________. . . . . . . . .... ................... ................ Width: _________________Length:_________________ Identification Number (VIN):_______________________ (3) The above described manufactured home is subject to a security lien and all secured parties with mailing addresses are listed below: THE PEOPLE OF THE STATE OF NEW YORK _________________________________________________________ _________________________________________________________ TO (4) Full legal description of new property to which manufactured home is to be affixed using metes and bounds or reference to recorded plat by book and page. (A separate sheet identified as 'Exhibit A' may be attached.) _____________________________________________________________________________________________ ______________________________________________________________________________ (5) Derivation: This being the identical or a portion of property conveyed or leased to the owner by deed or lease GREETINGS: from __________________________________________ and recorded ______________ in Book _______ at page _____________________. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Tax map number______________________ , the Honorable address__________________________________________Court at the Tax billing located at County of (6) Name of owner of real property if different from owner of manufactured home. _________________________________________________________ o'clock in the in room , on the day of , 20 , at noon, and at any recessed (7) The date, of the manufactured home affidavit was recorded on ____________________, or adjourned owner to testify and give evidence as a witness in this action on the part of the in book _____________, at page __________________, in the County of ___________________. The owner certifies that the above information provided by the owner is true and correct to the best information and belief of the owner. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Date:____________________ ___________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Signature of Owner result of your failure to comply. ___________________________ Type or print name of owner Witness:______________________ Witness, Honorable , one of the Justices of the , 20 Court in Witness:______________________ County, day of (Attorney must sign above and type name below) STATE OF SOUTH CAROLINA ) COUNTY OF _______________ ) PROBATE Before me, the undersigned Notary Public, personally appeared Attorney(s) for ______________________________, who, being duly sworn, deposed and said that he saw ___________________________________, sign, seal, and deliver the foregoing Affidavit and that he, together with ____________________________ witnessed the execution thereof. Office and P.O. Address ______________________________ SWORN to before me this _________ day of _______________ Notary Public for________________(L.S.) My Commission Expires:________ Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com