COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.PROBATE COURT OF MONTGOMERY COUNTY, OHIOALICE O. McCOLLUM, JUDGE JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)IN THE MATTER OF CASE NO.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .VERIFICATION OF RECEIPT AND DEPOSIT [Not for use in Custodial Account]was deposited with Pursuant to Court order, the sum of $THE PEOPLE OF THE STATE OF NEW YORK TOon theday of,as evidenced by Savings/Certificate of Deposit Account NumberThis account is held solely in the nameof, a minor, whose SocialGREETINGS:Security Number isWE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the Honorable,located at County ofo'clock in the day ofnoon, and at any recessed room, on the, 20, at adjourned date, to testify and give evidence as a witness in this action on the part of theBy accepting said deposit for said minor, this institution agrees that said deposit, together with accumulated interest, shall be held and no part thereof released until said minor attains the age of majority or upon further order of this Court.Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to 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 theFinancial InstitutionCourt in Witness, Honorableday of, 20 County,By:Authorized Officer(Attorney must sign above and type name below)Typed or Printed NameAttorney(s) forPhone NumberDateOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com04/01/97FORM 22.3 -VERIFICATION OF RECEIPT AND DEPOSIT
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