Employee Records Subpoena Response
Requestor Information
Name:
Organization/Law Firm:
Address:
Phone:
Email:
Employee Information
Employee Name:
Employee ID/Number:
Department/Position:
Dates of Employment:
Subpoena Details
Date Served:
Case Number:
Court/Jurisdiction:
Requested Records:
Deadline for Response:
Response
Description of Documents Provided:
If Any Documents Withheld, Reason(s):
Certification
Certified By (Name & Title):
Date: