COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.UNITED STATES BANKRUPTCY COURTJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)EASTERN DISTRICT OF LOUISIANAIN THE MATTER OFBANKRUPTCY NO.DEBTOR(S)CHAPTERAddress: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Social Security No(s).: Employer's Tax ID No.: THE PEOPLE OF THE STATE OF NEW YORK TODISCLOSURE OF COMPENSATION OF BANKRUPTCY PETITION PREPARER1. Under 11 U.S.C. ยง110 (h), I declare under penalty of perjury that I am not an attorney or employee of an attorney, that I prepared or caused to be prepared one or more documents for filing by the above-named debtor(s) in connection with this bankruptcy case, and that compensation paid to me within one year before the filing of the bankruptcy case, and that compensation paid to me within one year before the filing of the petition in bankruptcy, or agreed to be paid to me, for services rendered or to be rendered on behalf of the debtor(s) in contemplation of or in connection with the bankruptcy case is as follows:GREETINGS: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 roomFor document preparation services, I have agreed to accept $Prior to the filing of this statement I have received $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.Balance Due ..$2. I have prepared or caused to be prepared the following documents (itemize):, one of the Justices of theCourt in Witness, Honorableday of, 20 County,and provided the following services (itemize):(Attorney must sign above and type name below)3. The source of the compensation paid to me was:[ ] Debtor [ ] Other (specify)Attorney(s) for4. The source of the compensation to be paid to me is:[ ] Debtor [ ] Other (specify)Office and P.O. Address5. To my knowledge no other person has prepared for compensation a document for filing in connection with this bankruptcy case except as listed below: Telephone No.: Facsimile No.: E-Mail Address: NAMESOCIAL SECURITY NUMBERMobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
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