COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)TO ALL DEFENDANTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IF YOU ARE PLANNING TO MAKE APPLICATION WITH THE PUBLIC DEFENDER'STHE PEOPLE OF THE STATE OF NEW YORK TOOFFICE, PLEASE TAKE THE FOLLOWING WITH YOU TO THEIR OFFICE.CRIMINAL COMPLAINT SHEETGREETINGS:AFFIDAVIT OF PROBABLE CAUSEWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorablePROOF OF INCOME,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 roomAPPLICATIONS MUST BE MADE AT LEAST 3 DAYS PRIOR TO A SCHEDULEDHEARING DATE.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.IF YOU HIRE PRIVATE COUNSEL, PLEASE NOTIFY THIS OFFICE IMMEDIATELY., one of the Justices of theCourt in Witness, Honorableday of, 20 County,WASHINGTON COUNTY PUBLIC DEFENDER'S OFFICE 100 WEST BEAU STREET 605 COURTHOUSE SQUARE WASHINGTON, PENNSYLVANIA 15301 PHONE: (724) 228-6818(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.APPLICATION FOR THE ASSIGNMENT OF COUNSELPUBLIC DEFENDERJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)P/D NO. DATE:NAME:HOME ADDRESS:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .CITY:STATE:ZIP CODE:PHONE NO.:--SOCIAL SECURITY NO.:--THE PEOPLE OF THE STATE OF NEW YORK TODATE OF BIRTH:AGE:SEX: MALE/FEMALEMARITAL STATUS:NAME OF SPOUSE:GREETINGS:ADDRESS: (if different)WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableSPOUSE'S PH. NO.--NAME AND AGES OF CHILDREN/DEPENDANTS:,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 roomIF SINGLE, NAME OF PARENTS:PARENTS ADDRESS:PHONE NO.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.(If parents are deceased, list) NEAREST RELATIVE:PHONE NO.PRESENT CHARGE:, one of the Justices of theCourt in Witness, Honorableday of, 20 County,ARREST DATE:PLACE:TIME:(Attorney must sign above and type name below)TOWNSHIP:CITY:STATE:I AM UNABLE TO OBTAIN COUNSEL TO DEFEND ME BECAUSE:Attorney(s) forMAG. HEARING DATE:MAGISTRATE:TIME:Office and P.O. AddressCASE NO.:OTN:Telephone No.: Facsimile No.: E-Mail Address:WHAT IS YOUR BOND STATUS?BOND PAID BY WHOM?Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.EMPLOYMENTARE YOU EMPLOYED?If yes, NAME, ADDRESS AND PHONE NO. OF EMPLOYER:JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)GROSS MONTHLY WAGESIf married, IS YOUR SPOUSE EMPLOYED?NAME, ADDRESS AND PHONE NO. OF SPOUSE'S EMPLOYER:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .SPOUSE'S GROSS MONTHLY INCOME:IF UNEMPLOYED, WHEN AND WHERE DID YOU WORK LAST?THE PEOPLE OF THE STATE OF NEW YORK TOIF UNEMPLOYED, SOURCE OF INCOME:AMOUNT:CASE WORK (D.P.A.):WHAT OFFICE:GREETINGS:DO YOU HAVE ANY MONEY IN BANK OR OTHER INSTITUTION?AMOUNT:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,DO YOU OWN STOCKS, BONDS, PERSONAL PROPERTY?VALUE: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 roomDO YOU OWN REAL ESTATE?DESCRIPTION, LOCATION, VALUE:EDUCATIONYour 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.NUMBER OF YEARS COMPLETED:WHAT SCHOOL:HAVE YOU ANY VOCATIONAL OR TECHNICAL TRAINING?, one of the Justices of theCourt in Witness, Honorableday of, 20 County,WHERE?COLLEGE:WHERE?ARMED FORCES LENGTH OF SERVICE:(Attorney must sign above and type name below)TOBRANCH:TYPE OF DISCHARGE:RANK:Attorney(s) forADULT CRIMINAL RECORD HAVE YOU ANY PRIOR CRIMINAL RECORD:WHAT COUNTY:Office and P.O. AddressDATE AND PLACE OF ARREST:CHARGE AND DISPOSITION:Telephone No.: Facsimile No.: E-Mail Address:ARE YOU CURRENTLY ON PROBATION/PAROLE? YES/NO OFFICER:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.HEALTH RECORD DO YOU HAVE A PROBLEM WITH DRUGS AND/OR ALCOHOL?JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)ARE YOU RECEIVING COUNSELING OR TREATMENT?IF SO, WHERE AND BY WHOM?HAVE YOU EVER BEEN CONFINED TO A MENTAL INSTITUTION?IF SO, WHERE AND. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PERIOD OF CONFINEMENT:DO YOU HAVE ANY SERIOUS ILLNESSES OR DISABILITIES?THE PEOPLE OF THE STATE OF NEW YORK TOCASE INFORMATIONGREETINGS:1.NAMES AND ADDRESSES OF ALL WITNESSES FOR DEFENDANT: (A)(B)(C)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 room2.NAMES AND ADDRESSES OF
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