California > Local County > Placer
Family Court Services Worksheet - California
| Family Court Services Worksheet Form. This is a California form and can be used in Placer Local County . |
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COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : PLACER COUNTY FAMILY COURT SERVICES WORK SHEET Both parties should complete ALL information on the FORM. Legibly and in ink only. Please print. Index No. : Calendar No. Case Number:____________________________________ : JUDICIAL SUBPOENA Plaintiff(s) Indicate other Placer County cases filed in this Court, i.e.: Guardianship, Juvenile, Criminal -against: Case no.: ______________ Title of Case: ___________________________________________ Case no.: ______________ Title of Case: ___________________________________________ : _________________________________________ vs. ________________________________________________ : Petitioner Respondent _________________________________________ ________________________________________________ : Mailing .Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Defendant(s) . . . . . .Address Mailing . ...... .......... _________________________________________ ________________________________________________ City, State, Zip Code City, State, Zip Code _________________________________________ ________________________________________________ Telephone Number / Message Number OF NEW YORK Telephone Number / Message Number THE PEOPLE OF THE STATE _________________ ______________________ _______________________ ______________________ Date of Birth Driver's License # Date of Birth Driver's License # TO _________________________________________ ________________________________________________ Social Security Number Social Security Number _________________________________________ ________________________________________________ Place ofGREETINGS: Employment Place of Employment _________________ _____________________ _______________________ ______________________ City Work Phone City being laid aside, you and Workof you attend before WE COMMAND YOU, that all business and excuses each Phone Significant Other's Name: ____________________ Significant Other's Name: __________________________ , the Honorable at the Court Other Cases Related to the Family? ____________ Other Cases Related to the Family? ___________________ located at County of _________________________________________ ________________________________________________ in room , on the day of , 20 , at o'clock in the noon, and at any recessed Attorney's Name Attorney's Name or adjourned date, to testify and give evidence as a witness in this action on the part of the _________________________________________ ________________________________________________ Attorney's Full Address Attorney's Full Address _________________________________________ ________________________________________________ Attorney's Telephone Numberto comply with this subpoena is punishable asTelephone Number and will make you liable to Attorney's a contempt of court Your failure the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Full names of minor children to comply. Age Birthdate Primary Residence Name of school . result of your failure Date: _______________________ ______________________________ ___ _________ Witness, Honorable Court in County, of ______________________________ ___ day _________ ______________________________ ______________________________ ___ ___ _________ _________ __________________ ________________ , one of the Justices of the , __________________ 20 ________________ __________________ __________________ ________________ ________________ (Attorney must sign above and type name below) IMPORTANT INFORMATION Attorney(s) for _______________ Previous Mediator _____________________ Dates of Prior Mediation(s_ _________________ Separation Date __________________ Length of Relationship MUST BE COMPLETED Mediator / Court Use Only ____ Agree at Assessment (case concluded) Office and Case Address P.O. Disposition _____ Refer to FCS Evaluation _____ Refer to FCS Investigation Is there a history of domestic violence? ____yes or ____ no Request for separate mediation? ____ Agree/rec at Assessment (case concluded) ____ Rec at Assessment (case concluded) ______ yes or ______no Telephone No.:Focus:______________________________ _____ Facsimile No.:Refer to Private Evaluation E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com
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