COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. Notary Public Notification of Change of Name and Request to Correct Record : JUDICIAL SUBPOENA Plaintiff(s) -against- Please complete this form in its entirety. Print Legibly. : : : Previous name (as notary public commission issued) Defendant(s) : ...................................................... Date commission issued Date of name change THE PEOPLE OF THE STATE OF NEW YORK Changed by - check oneTO ( ) court order or ( ) marriage New name GREETINGS: (as appears on new notary seal and to correct record) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court Present mailing address located at County of (street, route and/or box number) in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the (city, state and zip code) 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(county) of $50 and all damages sustained as a penalty result of your failure to comply. I hereby submit this notification of change of name and request that all records in the Office of the Secretary of Honorable Witness, State pertaining to my appointment and commission as notary public beof the , one of the Justices corrected. Court in County, day of , 20 (Signature) Imprint of new seal here (Date) (Attorney must sign above and type name below) Attorney(s) for Return to: Chris Nelson Secretary of State Office and P.O. Address 500 E. Capitol Pierre, SD 57501-5077 (605)773-3539 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com