COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PROBATE COURT OF HAMILTON COUNTY, OHIOJAMES CISSELL, JUDGECalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s), MINORGUARDIANSHIP OFCASE NO.AFFIDAVIT OF INCOME AND EXPENSES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .STATE OF OHIO, COUNTY OF HAMILTON, SS.Now comesparent/guardian of (Name of Affiant)(Name of Minor) who being duly sworn and cautioned, states as follows:THE PEOPLE OF THE STATE OF NEW YORK TO1.from the funds on deposit at I am requesting the release ofGREETINGS:held in the name of 2.The purpose of the request for the release of funds isWE 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 room3.My marital status isand the number of members in my household is4.I am employed withand my annual salary is $and his/her annual 5.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.I state that my spouse is employed with salary is $ My current monthly household expenses are as follows: 6., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mortgage/Rent UtilitiesFood ClothingMedicalInstallment Loans Credit Cards Insurance Child Support Spousal Support TOTAL EXPENSESMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com02/10/03H.C. FORM 116.70 -AFFIDAVIT OF INCOME AND EXPENSESPage 1 of 2COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.CASE NO.Calendar No.Household Income: 7.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)AFFIANTSPOUSEOTHER ADULTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TONet Wages Stock Dividends Interest Social Security Worker's Comp. VA Benefits Annuity/Pension Child Support Spousal Support TOTALTOTAL -ALL INCOME FOR HOUSEHOLD $GREETINGS:$$$WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,8.I am unable to pay for the proposed expenditure becauselocated 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 roomYour 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., one of the Justices of theAffiantCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)personally appeared before me On thisday ofname hereon. , who being properly sworn and cautioned, did affix hAttorney(s) forNotary PublicOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comPage 2 of 2H.C. FORM 116.70 -AFFIDAVIT OF INCOME AND EXPENSES
|
Get this form for FREE as a print-only pdf
