COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF LUCAS COUNTY, OHIO JACK R. PUFFENBERGER, JUDGEJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN THE MATTER OF:CASE NO. Return of Service Respondent, alleged to be Mentally Ill.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOI received this writ of service (personal) re: above named respondent on at o'clock .M. Said writ included the following documents: GREETINGS:Affidavit Certificate of exam WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorablePrescreening from community mental health agency ,Application for Court Ordered medication 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 roomAuthorization for Court Ordered medication Agency request form Family history of patient Municipal Court records 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.Common Pleas Court records Request for Continued Commitment Motion for Return to More Restrictive Environment Discharge/Probable Cause Hearing Request, one of the Justices of theCourt in Witness, Honorableday of, 20 County,I made personal service of the writ and all documents noted above by delivering a true copy thereof personally to on at o'clock .M.(Attorney must sign above and type name below)Attorney(s) for Process Server for Lucas County Probate CourtOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:«ni318mdJ-Mobile Tel. No.:7/1/02FORM MH-207LC-RETURN OF SERVICEAmerican LegalNet, Inc. www.USCourtForms.com
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