COURT COUNTY OFAuthorization to Cancel Electronic and Bank-By-Mail Direct Deposit(12/19/03) CCSD 0002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.OFFICE OF THE CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOISCalendar No.Child Support 28 North Clark Street Room 200 Chicago, Illinois 60602 Phone: (312) 603-2000 Fax: (312) 345-4146JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)AUTHORIZATIONTOCANCELELECTRONICANDBANK-BY-MAILDIRECTDEPOSITPLEASE WRITE THE ACCOUNT NUMBER YOU WANT US TO CANCEL ON THIS FORM!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOI am currently a participant in the Clerk's and/or SDU's direct deposit program, but hereby request to be cancelled from this program. I understand that my child support payments will be mailed to the address on our system until further instructions are received. NAME: COURT DOCKET NUMBER: DAY TIME PHONE NUMBER: () BANK NAME: BANK CITY: BANK ROUTING NUMBER: ACCOUNT NUMBER:GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomTYPE OF ACCOUNT (CIRCLE ONE)CHECKING SAVINGSYour 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. // SIGNATUREDATE SIGNEDNOTARY: Please put your seal in this space, one of the Justices of theCourt in Witness, Honorableday of, 20 County,Subscribed and sworn to before me this:(Attorney must sign above and type name below) day of , My commission expires //Check if seal is embossed Attorney(s) forNotary Public Signature= = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = FOR COMPANYUSE ONLY Old & New Att'd: Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Deleted from PNDD on: //Terminated from SDU on: //Deleted from T-KIDS on: //Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comDOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
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