COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA DOMESTIC RELATIONS SECTIONJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)REQUEST FOR TELEPHONE CONFERENCE / HEARING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,I hereby request that I be permitted to provide testimony by telephone for the hearing scheduled on the date set forth below.I understand that the telephone number that I provide below I must be available to be reached at the time scheduled for the hearing and for up to one (1) hour following the scheduled time. I understand that if the Conference and/or Hearing Officer contacts me at this telephone number and I do not answer or am unavailable for any reason, that the hearing shall proceed without my testimony and that my opportunity to offer testimony will be lost. I also understand that if I am normally entitled to representation by the IV-D Attorney, that no representation will be provided if I elect to testify by telephone. I understand that when I am called by the Conference and/or Hearing Officer, he or she will provide to me a telephone number for the assigned courtroom to which I must make a return telephone call. I understand that I must pay for the cost of this call and that the Court will not bear the costs associated with my telephone testimony except to contact me with the return call number at the commencement of the hearing. I also understand that if I believe I am indigent and unable to pay for the cost of this call, I must contact the Domestic Relations Section and complete and file with the Court a Petition to Proceed In Forma Pauperis and ask the Court to bear the cost for my telephone testimony. If I choose to file an In Forma Pauperis petition, I must do so in sufficient time prior to the hearing so as not to delay the hearing date.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 roomI understand that this request must be made and received by the Court, either by mail or by fax, not later than five (5) days prior to the hearing date. By signing below, I acknowledge that I have read and understand the requirements set forth above.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. PRINT YOUR NAME HERESIGN YOUR NAME HERE-------------------------------------------------------------------------------------------------------------------------------- THE FOLLOWING INFORMATION MUST BE COMPLETED OR THIS FORM WILL NOT BE ACCEPTED. Circle one:, one of the Justices of theCourt in Witness, Honorableday of, 20 County,I am thePLAINTIFFDEFENDANTThe name of the other party is:(Attorney must sign above and type name below)My hearing date is:My Docket Number is: My PACSES Case ID is:Attorney(s) forThe telephone number I may be reached is:() -------------------------------------------------------------------------------------------------------------------------------- RETURN THIS FORM TO:Office and P.O. AddressIntake Supervisor Domestic Relations Section Court of Common Pleas 100 W. Beau St., Ste. 301 Washington PA 15301 FAX: 724-228-6899Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
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