COURT COUNTY .OF. . . . . . . . . . . . . . WYOMING . STATE ......... .. ................. .......... : BAR Index No. CHANGE OF ADDRESS FORM : Calendar No. Each attorney is required to maintain a current address of record with the Wyoming State Bar. The following form may be used to update or correct your information on the Bar’s database. : JUDICIAL SUBPOENA Plaintiff(s) Please print or type: -against- : Attorney Name Attorney # : Firm Name : Office Street Address Defendant(s) : . . .Mailing. Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... ...... Office City/State/Zip THE PEOPLE OF THE STATE OF NEW YORK Office Phone Office Fax E-mail Address TO The following information is required but WILL NOT BE PUBLISHED: Residence Street Address GREETINGS: City/State/Zip WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , at the Court located at County of TRUST ACCOUNT CERTIFICATION & IOLTA PARTICIPATION in room , on the day of , 20 , at o'clock in the noon, and at any recessed I certify, under penalty of perjury, that Igive evidence understand Wyoming action on the part of the or adjourned date, to testify and have read and as a witness in this Rule of Professional Conduct 1.15 which requires the Honorable Residence Phone that all lawyers holding client or third party funds maintain a separate trust account for the deposit of such funds. My change of address did not affect my trust account. I. Your failure to comply by maintaining and is punishable as a I have complied with Rule 1.15with this subpoenausing a trust account.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 Financial Institution Address Account Number IOLTA Name of Signatory result of your failure to comply. YES Witness, Honorable Court in County, day of , 20 NO* , one of the Justices of the NO* YES *Notice & Authorization to Financial Institutions: Wyoming Rule of Professional Conduct 1.15(b) requires every lawyer who holds funds for cleints or third parties in Wyoming to participate in the Interest on Lawyer Trust Account Program unless written Notice of Declination is submitted to the Wyoming State Bar. Unless such a notice has been separately filed, the attorney hereby authorizes any financial institution in which the attorney maintains a trust account for client or third party funds to automatically, and without further documentation, convert his or her trust account described herein to an interest bearing IOLTA account subject of the provisions of the Wyoming Supreme Court Rules of Professional Conduct. The attorney authorizes and directs that interest earned on the account(s) be remitted to the Wyoming State Bar Foundation, TIN Number 74-2226269 below) Form W-9 & (Attorney must sign above and type name (for IRS 1099 returns). II. Rule 1.15 does not require me to maintain a trust account because: a. My private practice of law does not involve trust funds. Attorney(s) for b. I am a judge, attorney general, public defender, U.S. attorney, district attorney, on duty with the armed services, or employed by local, state, or federal government. c. I am a corporate counsel or teacher of law. d. My office is not in Wyoming, and I do not practice within Wyoming. e. Other Office and P.O. Address With this signature I certify under penalty of perjury that the above and foregoing information is true and correct. Signature Date Telephone No.: Facsimile No.: E-Mail Address: All address changes must be made in writing and can be sent by mail to the Wyoming State Bar, P.O. Box 109, Cheyenne, WY Mobileor faxed to (307) 632-3737. 82003 Tel. No.: American LegalNet, Inc. www.USCourtForms.com