Form 254 - Subpoena For Rule 2004 Examination (Page 2 of 3) in pdf

Form 254 - Subpoena For Rule 2004 Examination Page 2

B254 (Form 254 – Subpoena for Rule 2004 Examination) (12/13) (Page 2)

PROOF OF SERVICE

(This section should not be filed with the court unless required by Fed. R. Civ. P. 45.)

I received this subpoena for (name of individual and title, if any): ______________________________________________

on (date) __________ .

I served the subpoena by delivering a copy to the named person as follows: ____________________________________

___________________________________________________________________________________________________

__________________________________ on (date) ___________________ ; or

I returned the subpoena unexecuted because: ____________________________________________________________

___________________________________________________________________________________________________

Unless the subpoena was issued on behalf of the United States, or one of its officers or agents, I have also tendered to the

witness the fees for one day’s attendance, and the mileage allowed by law, in the amount of $ _______________________ .

My fees are $ _________ for travel and $_________ for services, for a total of $_________ .

I declare under penalty of perjury that this information is true and correct.

Date: _______________

________________________________________________

Server’s signature

________________________________________________

Printed name and title

________________________________________________

Server’s address

Additional information concerning attempted service, etc.:

Form 254 - Subpoena For Rule 2004 Examination Page 2