COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. CHILD CUSTODY INFORMATION SHEET NO: Plaintiff(s) : JUDICIAL SUBPOENA If you are seeking protection for your child(ren) from domestic violence or are requesting custody of -against: your child(ren), please answer the questions and provide the information requested in paragraphs A ­E below and check the boxes about the court's jurisdiction that apply to your case: : Information for the courts: : Yes No A. Do the child(ren) listed in Paragraph 5 of the petition currently live with you? If not, Defendant(s) : . . . . with. whom do .the .child(ren) .currently. live?. . . . . . . . . . . . . . . . . ... ....... .. ....... ...... ... B. Do you know of any other court cases involving the child(ren)? If known, list: THEthe court OF THE STATE OF NEW YORK PEOPLE the case number the kind of case Yes No TO C. Have you been involved in any other litigation concerning custody or visitation with Yes No the child(ren) in this or any other state? If known, list the court, the case number and GREETINGS: the date the parenting plan, residential schedule, visitation schedule or custody decree was entered: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of 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 D. Do you know of any persons, other than you and the respondent, who claims rights of Yes No custody or failure to with, thewith this subpoena is punishable as a contempt of court and will make you liable to visitation comply child(ren)? If known, list their names in the space Your provided below and their present addresses in the for a maximum penalty of $50 the party on whose behalf this subpoena was issued Confidential Information Form: and all damages sustained as a result of your failure to comply. Witness, Honorable , one of the Justices of the Court in the places where the children day of County, , past E. List have lived during the20 five years, the dates they lived there and the persons with whom they lived. (The present addresses of those persons must be listed in the required Confidential Information Form.) (Attorney must sign above and type name below) Jurisdiction: Attorney(s) for This court has jurisdiction over this proceeding for the reasons below: [Check all the boxes that apply to your case.] This court has exclusive continuing jurisdiction. The courtOffice andaP.O. Address parenting has made child custody, plan, residential schedule or visitation determination in this matter before and retains jurisdiction under RCW 26.27.211. CHILD CUSTODY INFORMATION SHEET - Page 1 of 2 WPF DV-1.030 (9/2001) - RCW 26.050.030, 26.27.201 ­ .291 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. This state is the home state of the children because: : JUDICIAL SUBPOENA the children lived in Washington with a parent or a person acting as a parent for at least six Plaintiff(s) consecutive months immediately before the beginning of this proceeding. -against: the children are less than six months old and have lived in Washington with a parent or a person acting as parent since birth. : any absences from Washington have been only temporary. Washington was the home state of the children within six months before the beginning of this : proceeding and the children are absent from the state; but a parent or person acting as a parent continues to live in this state. Defendant(s) : . . . . . . The .children . . . .the .parents,. or the. children. and at. least. one .parent or a person acting as a parent, . . . . . . . . . and . . . . . . . . . . . . . . . . . . . . . . . . . . . have significant connections with this state other than mere physical presence; and substantial evidence is available in this state concerning the children's care, protection, training and personal relationships and THE PEOPLE OF THE STATE OF NEW YORK the children have no home state elsewhere. the children's home state has declined to exercise jurisdiction on the ground that this state is TO the more appropriate forum under RCW 26.27.261 or 271. All courts in the children's home state have declined to exercise jurisdiction on the ground that a court of this state is the more appropriate forum to determine the custody of the children under RCW 26.27.261 or .271. GREETINGS: No other state has jurisdiction. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before This court has temporary emergency jurisdiction over this proceeding because the children are , the Honorable at the Court present in this state and the children have been abandoned, or it is necessary in an emergency to located at County of protect the children because the children, or a sibling or parent of the children is subjected to or in room , on the day of , 20 , at o'clock in the noon, and at any recessed threatened with abuse. RCW 26.27.231. or adjourned date, to testify and give evidence as a witness in this action on the part of the I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Dated at , Washington 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 County, , one Petitionerof the Justices of the day of , 20 Court in (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address CHILD CUSTODY INFORMATION SHEET - Page 2 of 2 WPF DV-1.030 (9/2001) - RCW 26.050.030, 26.27.201 ­ .291 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com