AO 110 (Rev. 01/09) Subpoena to Testify Before a Grand Jury
UNITED STATES DISTRICT COURT
for the Northern District of Oklahoma SUBPOENA TO TESTIFY BEFORE A GRAND JURY
To:
YOU ARE COMMANDED to appear in this United States district court at the time, date, and place shown below to testify before the court's grand jury. When you arrive, you must remain at the court until the judge or a court officer allows you to leave.
Place:
Date and Time:
You must also bring with you the following documents, electronically stored information, or objects (blank if not
applicable):
Date:
CLERK OF COURT
Signature of Clerk or Deputy Clerk
The name, address, e-mail, and telephone number of the United States attorney, or assistant United States attorney, who requests this subpoena, are:
AO 110 (Rev. 01/09) Subpoena to Testify Before Grand Jury (Page 2)
PROOF OF SERVICE
This subpoena for (name of individual or organization) was received by me on (date) .
' I personally served the subpoena on the individual at (place) on (date) ' I left the subpoena at the individual's residence or usual place of abode with (name) , a person of suitable age and discretion who resides there, on (date) , and mailed a copy to the individual's last known address; or , who is on (date) ' I returned the subpoena unexecuted because ' Other (specify): . ; or ; or ; or
' I served the subpoena on (name of individual) designated by law to accept service of process in behalf of (name of organization)
I declare under penalty of perjury that this information is true.
Date:
Server's signature
Printed name and title
Server's address
Additional information regarding attempted service, etc:
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