COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOSUPERIOR COURT OF WASHINGTON COUNTY OF JUVENILE COURT STATE OF WASHINGTON v.NO:WAIVER OF LAWYER (Juvenile/Child) (WVC)GREETINGS:Respondent(s). D.O.B.:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,The undersigned states that: 1.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 know that I have the right to have a lawyer with me to represent me in these proceedings;2.I know that I will not have to pay for a lawyer if I cannot afford it;3.I have decided not to be represented by a lawyer.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.Dated: RESPONDENT/CHILDJUDGE'S CERTIFICATE, one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)The foregoing statement was read by or to the above-named respondent/child and signed in the presence of the undersigned judge in open court. The respondent/child was afforded the opportunity to ask questions about this waiver. The court finds the waiver of a lawyer to be knowingly, intelligently, and voluntarily made. The court finds the respondent/child is under 12 years of age and the approval and signature of a parent, guardian, or custodian is required.Attorney(s) forDated: PARENT/GUARDIAN/CUSTODIANDated: JUDGE/COMMISSIONEROffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:WAIVER OF LAWYER (JUVENILE/CHILD) (WVC) -Page1of1 WPF JU 09.0210 (9/2000) -RCW 13.32A.160; 13.34.090; 13.40.080, .140Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
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