Custody Intake Information Sheet

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Custody Intake Information Sheet:::::::Index No.Child(ren)'''''s Information:Calendar No.//Child's Last name,FirstBirthdateAgechild living withJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)// Child's Last name,FirstBirthdateAgechild living with// Child's Last name,FirstBirthdateAgechild living with// Child's Last name,FirstBirthdateAgechild living with. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .MOTHER:FATHER:Last nameFirst nameMILast nameFirst nameMITHE PEOPLE OF THE STATE OF NEW YORK TONumberStreetApt.NumberStreetApt.CityStateZipCityStateZipGREETINGS:Phone #/Social Security #Phone #/Social Security #WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,//// BirthdateBirthdateHow was paternity established?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 roomFATHER: (Additional if necessary)Children's Guardian, Legal Custodian orAttorney (if applicable):Last nameFirst nameMILast nameMIFirst nameYour 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.NumberStreetApt.NumberApt.StreetCityStateZipZipStateCity, one of the Justices of theCourt in Witness, Honorableday of, 20 County,Phone #/Social Security #Social Security #/Phone #//PATERNITY REGISTRY #BirthdateHow was Paternity established?(Attorney must sign above and type name below)HAVE THE ABOVE NOTED PARENTS EVER BEEN MARRIED TO EACH OTHER?YES NOIF YES, PLEASE SPECIFY THE DATE OF MARRIAGE YES NOARE THEY DIVORCED?IF YES, PLEASE SPECIFY THE DATE OF DIVORCE APPLICANT:relationship to childStaff Use Only:Attorney(s) forPaternityCase #Last nameFirst nameMIRelated CasesFamily #NumberStreetApt.Office and P.O. AddressChecked by:CityStateZipPhone #Social Security #/Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com</document>