UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF NEW YORK

_________________________________

__________ __________,

Plaintiff, Civil Action No. __:__-CV-____

v.

__________ __________,

Defendant(s).
_________________________________

REQUEST FOR SUBPOENA(S)

I, __________ __________, pro se litigant, am requesting the issuance of subpoena(s) as

noted below, pursuant to Federal Rule of Civil Procedure 45(a)(1) and (2).

____ Subpoena(s) to Testify and/or Produce Document(s) at Trial or Hearing1

• Trial or hearing set for ____________ ___, _____, before the Hon. ________________
(Please note that such subpoenas will not be issued if there is no date set for the
trial or hearing.)

• Names and addresses of each witness to be subpoenaed:

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

• Brief justification or reason for each subpoena requested:

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

1
Pursuant to Federal Rule of Civil Procedure 45(b)(1), if the subpoena requires the
named person’s attendance, the fees for 1 day’s attendance and the mileage allowed by law must
be tendered at the time of service.
____ Subpoena(s) to Attend Deposition1

• Deposition scheduled for ____________ ___, _____, in ____________, ____________.

• Names and addresses of each witness to be subpoenaed:

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

• Brief justification or reason for each subpoena requested:

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

____ Subpoena(s) for Production and/or Inspection

• Description of the document(s) requested and/or premises to be inspected:

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

• Brief justification or reason for each subpoena requested:

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

I hereby certify that the number of subpoena(s) requested complies with the Federal Rules of
Civil Procedure.

______________________ ____________________
Pro Se Litigant Date of Request

The above request is hereby ______________________

_________________________ ________________________
Hon. Date