COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... SUPERIOR COURT OF WASHINGTON COUNTY OF _______________________ THE PEOPLE OF THE STATE OF NEW YORK JUVENILE COURT TOSTATE OF WASHINGTON v. NO: GREETINGS: Respondent(s). D.O.B.: WAIVER OF LAWYER (Juvenile/Child) (WVC) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court The undersigned states that: located at County of in1. room I know that I have the right of have a lawyer with me to represent mein the , on the day to , 20 , at o'clock in these proceedings; any recessed noon, and at or adjourned date, to testify and give evidence as a witness in this action on the part of the 2. I know that I will not have to pay for a lawyer if I cannot afford it; 3. I have decided not to be represented by a lawyer. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party __________________________was issued for a maximum penalty of $50 and all damages sustained as a Dated: on whose behalf this subpoena ____________________________________________ result of your failure to comply. RESPONDENT/CHILD JUDGE’S CERTIFICATE Witness, Honorable , one of the Justices of the Court foregoing statement was read day of the above-named respondent/child and signed in the County, , 20 The in by or to presence of the undersigned judge in open court. The respondent/child was afforded the opportunity to ask questions about this waiver. The court finds the waiver of a lawyer to be knowingly, intelligently, and voluntarily made. (Attorney must sign above and type name below) q The court finds the respondent/child is under 12 years of age and the approval and signature of a parent, guardian, or custodian is required. Attorney(s) for Dated: __________________________ ____________________________________________ PARENT/GUARDIAN/CUSTODIAN Dated: __________________________ _____________________________________________ Office and P.O. Address JUDGE/COMMISSIONER Telephone No.: No.: E-Mail Address: Mobile Tel. No.: WAIVER OF LAWYER (JUVENILE/CHILD) (WVC) - Page 1 of 1 Facsimile WPF JU 09.0210 (9/2000) - RCW 13.32A.160; 13.34.090; 13.40.080, .140 American LegalNet, Inc. www.USCourtForms.com