IN THE WORKERS' COMPENSATION COURT OF THE STATE OF MONTANA

WCC No. ___________________


_______________________________
Petitioner

vs.

______________________________

Respondent/Insurer.
 

SUBPOENA DUCES TECUM

THE STATE OF MONTANA, to ____________________________________.

 You are hereby required, all business and excuses laid aside, to appear before the Workers' Compensation Court of the State of Montana at __________________________ in the City of ____________, Montana, on the _____ day of ___________, 200_ , at _____ o'clock then and there to testify in the above-entitled matter now pending in the said Workers' Compensation Court on behalf of the and to produce at the said time and place books, records and documents as follows: ______________________________________________
_______________________________________, unless quashed or until judgment, dismissal, or other final determination of this action by the Court. For failure to appear, you will be liable to punishment for contempt as provided by law.

            DATED in Helena, Montana, this _____ day of __________________, 200_.

                                                                                    By:____________________________________
                                                                                            (Signature of Attorney)