COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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NAME AND ADDRESS OF COURT: : Index No. FOR COURT USE ONLY
: Calendar No.
:
NAME OF DEFENDANT: Plaintiff(s) JUDICIAL SUBPOENA
STREET ADDRESS: -against- :
MAILING ADDRESS:
CITY AND ZIP CODE:
:
DATE OF COURT ORDER: :
(check one)
Defendant(s) :
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PROOF OF ENROLLMENT IN ALCOHOL OR DRUG PROGRAM
CASE NUMBER:
PROOF OF COMPLETION OF ALCOHOL OR DRUG PROGRAM
THE PEOPLE OF THE STATE OF NEW YORK
DESCRIPTION OF ALCOHOL OR DRUG PROGRAM
TO
Name of Program:
Address of Program:
Program License Number: Program Telephone Number:
GREETINGS: PROOF OF ENROLLMENT
1. Defendant (name): enrolled in the alcohol or drug
WE COMMAND YOU, that all business and
education program described above on (specify date of enrollment): excuses being laid aside, you and each of you attend before
the Honorable
I declare under penalty of perjury under the laws of the State of at the Court
California that the foregoing is true and correct. ,
Date: County of located at
in room , on the , 20 , at
day of o'clock in the
................................................................................................ noon, and at any recessed
(TYPE to testify and
or adjourned date,OR PRINT NAME) give evidence as a witness in this action on the part of the
(SIGNATURE OF DEFENDANT)
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF PROGRAM DIRECTOR OR INSTRUCTOR)
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
and
the party on whose behalf this subpoena was issued for a maximum penalty of $50(TITLE) all damages sustained as a
result of your failure to comply.
PROOF OF COMPLETION
2. Defendant (name): successfully completed the alcohol or drug
Witness, Honorable , one of the Justices of the
education program described above on (specify date of completion):
Court in County, day of , 20
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
................................................................................................
(TYPE OR PRINT NAME) (SIGNATURE OF DEFENDANT)
(Attorney must sign above and type name below)
Date:
................................................................................................
(TYPE OR PRINT NAME) (SIGNATURE OF PROGRAM DIRECTOR OR INSTRUCTOR)
Attorney(s) for
(TITLE)
YOU NEED TWO OF THESE FORMS: — INSTRUCTIONS —
1. UPON ENROLLMENT IN A COURT-ORDERED ALCOHOL OR DRUG EDUCATION PROGRAM, FILL OUT THE PROOF OF
Office and P.O. Address
ENROLLMENT PORTION OF ONE COPY OF THIS FORM AND FURNISH IT TO THE SENTENCING COURT WITHIN THE TIME AND IN
THE MANNER SPECIFIED BY THE COURT.
2. UPON SUCCESSFUL COMPLETION OF THE PROGRAM, FILL OUT THE PROOF OF COMPLETION PORTION OF A SECOND COPY OF
THIS FORM AND FURNISH IT TO THE SENTENCING COURT WITHIN THE TIME AND IN THE MANNER SPECIFIED BY THE COURT.
Telephone No.:
FAILURE TO COMPLY WITH THESE REQUIREMENTS MAY RESULT IN THE REVOCATION OF YOUR PROBATION.
Facsimile No.:
Sl USTED NO CUMPLE CON ESTOS REQUISITOS, SU INCUMPLIMIENTO PUEDE RESULTAR EN LA REVOCACION DE SU LIBERTAD
CONDICIONAL.
E-Mail Address:
Form Approved by the
Judicial Council of California
Mobile Tel.
PROOF OF ENROLLMENT OR COMPLETION No.: Veh. Code, §23205
MC-400 [Rev. January 1, 1986] ALCOHOL OR DRUG PROGRAM American LegalNet, Inc.
www.USCourtForms.com