COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : S T A T E O F W I S C O N S I N C I R C U I T C O U R T FAMILY COURT BRANCH In re the Paternity of:____________ -against- Plaintiff(s) : : Index No. CalendarRNo.I C O S T . X C O U N T Y JUDICIAL SUBPOENA CASE TYPE: PATERNITY : CASE CODE: 40501 _____________________________, Petitioner : PETITION and : : _______________________,. . . . . . . . . .Defendant(s) . . . # ._____ PA ________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . Respondent . . . . . . . Case . . . . .. Petitioner states as follows: THE PEOPLE OF THE STATE OF NEW YORK 1. TO That the child, ____________________________, born on _____________________________, in ________________; current resides with the mother, __________________________. 2. That the mother, _____________________________, born ________________________, currently resides at ______________________________, St. Croix County, State of Wisconsin; social security number ___________________________; home telephone number ______________, employer’s name, address and GREETINGS: number ______________________________________________________________________ and is telephone the mother of the child. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the3. The putative father, __________________________, born ________________________, currently resides at Honorable at the Court ____________________________; social security number ___________________________; home telephone located at County of number ______________, of employer’s , 20name, at address and in room , on the day , o'clock in the telephone and at any recessed noon, number ______________________________________________________________________ and upon information or adjourned date, to testify and give evidence as a witness in this action on the part of the and belief, is the father of the child. 4. That based on the child’s birth date, the conceptive period for this child is ______________________. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to 5. That the putative father and the mother of the child engaged in sexual intercourse on at least one occasion the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a during the above-mentioned conceptive period. result of your failure to comply. 6. That no other action to determine the paternity of the child or rebut the presumption of paternity to the child has been commenced, or is pending before any judge or court commissioner, in this State or elsewhere. of the Witness, Honorable , one of the Justices Court in 7. County, day of , 20 That the parties to this action have the right to request a blood test, pursuant to s. 767.48, Wis. Stats. PETITIONER REQUESTS THE FOLLOWING RELIEF: A. B. C. D. E. F. G. (Attorney must sign above and type name below) Determination of Petitioner/Respondent as father of the child, ____________________, dob: _____________. Contribution to the reasonable expenses of pregnancy and confinement. Child support and income assignment pursuant to § 767.265, Stats. Attorney(s) for Determination of legal custody and physical placement. Provision for health care insurance and contribution to uninsured health care expenses for the child. Repayment of service fees. And such other relief as is appropriate. Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Paternity Mobile Tel. No.: Forms Petition Page 1 of 2 Rev. 5/02 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Dated this __________ day of _____________________________, 2002.: Plaintiff(s) -against- Index No. Calendar No. JUDICIAL SUBPOENA : _____________________________________________ Petitioner appearing pro se : Subscribed and sworn to before me this ______ day of _______________, ________________. : ________________________________________________ Notary public, State of Wisconsin Defendant(s) : My commission . . . . . . .____________________________ . . . . . . . . . . . . . . . . . . . . . . expires: . . . . . . . . . . . . . . . . . . . . . . . . . THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: 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 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. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Divorce With Mobile -Tel.Minor Children No.: Forms Petition Page 2 of 2 MLRC Rev. 9/20/99 American LegalNet, Inc. www.USCourtForms.com