231 Pa. Code § 234.6
A subpoena issued pursuant to Rule 234.1 shall be substantially in the following form:
Commonwealth of Pennsylvania
County of__________________________________
(Caption)
SUBPOENA TO ATTEND AND TESTIFY
To ____________ :
(Name(s) of Witness(es))
(Specify courtroom or other place)
at ____________ , Pennsylvania, on ____________ at
__ o'clock, __ . M., to testify on behalf of ____________ in the above
case, and to remain until excused.
______________________________________
______________________________________.
If you fail to attend or to produce the documents or things required by this subpoena, you may be subject to the sanctions authorized by 234.5 of the Pennsylvania Rules of Civil Procedure, including but not limited to costs, attorney fees and imprisonment.
Requested by: ______________________________________
(Attorney's name, address, telephone number and identification number)
BY THE COURT,
Date: ____________
By ____________
Seal of the Court (Name of Prothonotary)
Note: This form of subpoena shall be used whenever a subpoena is issuable under Rule 234.1, including hearings in connection with depositions and before arbitrators, hearing officers, commissioners, etc.
To require the production of documents or things in addition to testimony, complete paragraph 2.
Return of Service: (Reverse side of Subpoena)
On the _______________ day of ____________ ,__________ , I ________________ , served ____________ with the fore-
(name of person served)
going subpoena by: (Describe method of service)
___________________________
______________________.
I verify that the statements in this return of service are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. § 4904 relating to unsworn falsification to authorities.
Date: _____________
_____________
(signature)
231 Pa. Code § 234.6