This form contains 40 fields organized into 15 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Information
Additional Information Text
Provide any additional information regarding attempted service or other relevant details.
Case Caption Information
Court District Combobox
Enter the district and division name (for example, "Northern District of California") of the United States District Court where the case is filed.
Western District of Louisiana District of Colorado Western District of Texas District of North Dakota Northern District of Iowa Middle District of Alabama Western District of Missouri District of Massachusetts Eastern District of North Carolina Eastern District of Wisconsin Northern District of Illinois Western District of Virginia Eastern District of Oklahoma Western District of Pennsylvania Eastern District of Texas Eastern District of Washington District of Puerto Rico Eastern District of Michigan Northern District of Indiana Northern District of Florida District of Minnesota District of Utah Southern District of Texas District of Hawaii District of South Carolina District of Delaware Southern District of California Eastern District of Kentucky Southern District of Georgia Middle District of Pennsylvania Western District of Arkansas District of Idaho Western District of New York Eastern District of Arkansas District of Connecticut Western District of Kentucky Eastern District of Missouri District of Guam Southern District of Illinois Western District of Tennessee District of the Virgin Islands Northern District of Texas District of Maryland Eastern District of Virginia Southern District of Florida District of Nevada Middle District of Louisiana District of Alaska Eastern District of California Southern District of New York Middle District of North Carolina Northern District of Alabama Southern District of Iowa District of Maine Northern District of Mississippi Eastern District of Louisiana Southern District of West Virginia Western District of Michigan District of New Jersey Southern District of Indiana Eastern District of New York Northern District of West Virginia District of New Mexico Western District of Oklahoma Northern District of Oklahoma District of Oregon Western District of Wisconsin District of Arizona Central District of Illinois Southern District of Alabama District of Vermont Western District of North Carolina Northern District of New York District of South Dakota Southern District of Mississippi District of the Northern Mariana Islands District of Wyoming Southern District of Ohio Northern District of Ohio Middle District of Florida Northern District of California Western District of Washington District of Columbia Eastern District of Pennsylvania Central District of California District of Montana Northern District of Georgia District of Rhode Island Middle District of Georgia District of Nebraska District of New Hampshire Middle District of Tennessee Eastern District of Tennessee District of Kansas
Case Information
Plaintiff Name(s) Text
Please provide the full name(s) of the plaintiff(s) in the civil action.
Civil Action Number Text
Please enter the civil action number for this case.
Defendant Name(s) Text
Please provide the full name(s) of the defendant(s) in the civil action.
Date
Date Issued Date
Provide the date the subpoena is issued.
General
PrintForm Button
ClearForm Button
Attach a file Button
Inspection of Premises Command
Inspection of Premises Checkbox
Check this box if the recipient is commanded to permit entry onto designated premises, land, or other property for inspection, measurement, survey, photography, testing, or sampling.
Inspection Place Text
Provide the address or description of the premises, land, or other property where the inspection will take place. Fill only if 'Inspection of Premises' is checked.
Depends on: Inspection of Premises
Inspection Date and Time Date
Provide the date and time when the inspection will occur. Fill only if 'Inspection of Premises' is checked.
Depends on: Inspection of Premises
Production Command
Production Command Checkbox
Check this box if the subpoena commands the recipient to produce documents, electronically stored information, or objects, and to permit inspection, copying, testing, or sampling of the material.
Production Material Description Text
Provide a detailed description of the documents, electronically stored information, objects, or material to be produced. Fill only if 'Production Command' is checked.
Depends on: Production Command
Production Place Text
Enter the physical location where the production of materials will take place. Fill only if 'Production Command' is checked.
Depends on: Production Command
Production Date and Time Text
Specify the date and time for the production of materials. Fill only if 'Production Command' is checked.
Depends on: Production Command
Requesting Attorney Information
Represented Party Name Text
Please provide the full name of the party that the attorney issuing or requesting this subpoena represents. Fill only if 'Attorney Signature' is signed.
Depends on: Attorney Signature
Attorney Information Line 1 Text
Please provide the first line of the requesting attorney's name, address, e-mail address, and telephone number. Fill only if 'Attorney Signature' is signed.
Depends on: Attorney Signature
Attorney Information Line 2 Text
Please provide the second line of the requesting attorney's name, address, e-mail address, and telephone number. Fill only if 'Attorney Signature' is signed.
Depends on: Attorney Signature
Server Fees
Travel Fees Number
Enter the total amount paid for travel expenses.
Service Fees Number
Enter the total amount paid for services rendered.
Total Fees Number
Enter the combined total amount for all fees, including travel and services.
Server's Declaration
Date Date
Enter the date when this declaration is made.
Server's Signature Text
Provide the signature of the server.
Printed Name and Title Text
Enter the printed name and title of the server.
Server's Address Text
Provide the complete address of the server.
Service Details
I served the subpoena by delivering a copy to the named person Checkbox
Check this box if you served the subpoena by delivering a copy to the named person.
Delivery Details Line 1 Text
Enter the first line of details explaining how the subpoena was delivered to the named person. Fill only if 'I served the subpoena by delivering a copy to the named person' is checked.
Depends on: I served the subpoena by delivering a copy to the named person
Delivery Details Line 2 Text
Enter the second line of details explaining how the subpoena was delivered to the named person. Fill only if 'I served the subpoena by delivering a copy to the named person' is checked.
Depends on: I served the subpoena by delivering a copy to the named person
Delivery Details Line 3 Text
Enter the third line of details explaining how the subpoena was delivered to the named person, which may include the location. Fill only if 'I served the subpoena by delivering a copy to the named person' is checked.
Depends on: I served the subpoena by delivering a copy to the named person
Date of Delivery Date
Enter the date on which the subpoena was delivered to the named person. Fill only if 'I served the subpoena by delivering a copy to the named person' is checked.
Depends on: I served the subpoena by delivering a copy to the named person
Signature
Clerk or Deputy Clerk Signature Text
Provide the signature of the Clerk of Court or Deputy Clerk.
Attorney Signature Text
Provide the signature of the attorney.
Subpoena Recipient
Subpoena Recipient Name Text
Please provide the full name of the person to whom this subpoena is directed.
Recipient Name and Title Text
Provide the full name of the individual who received the subpoena and their title, if any.
Date Received Date
Enter the date the subpoena was received.
Unexecuted Subpoena Details
Subpoena Unexecuted Checkbox
Check this box if the subpoena was not successfully executed or served.
Reason for Unexecuted Subpoena Text
Please provide the primary reason why the subpoena was returned unexecuted. Fill only if 'Subpoena Unexecuted' is checked.
Depends on: Subpoena Unexecuted
Additional Unexecuted Details Text
Please provide any additional details or further explanation regarding the unexecuted subpoena. Fill only if 'Subpoena Unexecuted' is checked.
Depends on: Subpoena Unexecuted
Witness Fees
Amount Tendered to Witness Number
Provide the total amount tendered to the witness for one day's attendance and mileage allowed by law. Fill only if 'I served the subpoena by delivering a copy to the named person' is checked.
Depends on: I served the subpoena by delivering a copy to the named person