Affidavit In Support Of Application To Resign While Proceeding Or Investigation Is Pending - Supreme Court Of The State Of New York Page 14

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24.

Other than the judgments set forth in paragraph 23 hereof, I have incurred the following

debts with a balance over $500 that are presently overdue by at least 60 days: [state the name and

address of each creditor, the nature of the debt, the original amount of the indebtedness and date

incurred, the due date, and the balance due].

- OR -

I attest to having no debts with a balance over $500 that are presently overdue by at least 60

days.

25.

Since the entry of the order of discipline, I have defaulted in the performance or

discharge of an obligation or duty imposed upon me by the following courts, and/or

governmental or administrative agencies: [state the nature of the obligation or duty, the court or

agency by which it was imposed, the date performance was due, and the reason for the default].

- OR -

I attest that, since the entry of the order of discipline, I have not defaulted in the performance or

discharge of an obligation or duty imposed upon me by any court, and/or governmental or

administrative agency.

26.

I or any firm, corporation, or business entity in which I have or had an ownership interest

filed a petition in bankruptcy on [date] to [court].

[Copies of any bankruptcy petitions, schedules, and or discharge orders are attached as exhibit

___ hereto.]

- OR -

I attest that neither I nor any firm, corporation, or business entity in which I have or had an

ownership interest has filed a petition in bankruptcy in any court.

27.

Since the entry of the order of discipline, I have filed all required federal, state, and local

income tax returns when due or have received an extension to file the same, except as follows:

[Copies of all such returns are attached as exhibit ___ hereto, and such returns have been

redacted in a manner consistent with Uniform Rules for Supreme Court and County Court (22

NYCRR) § 202.5 (e) (1) (i).]

28.

Since the entry of the order of discipline, I have applied for the following licenses that

required proof of good character: [state the nature of the license, the name of the licensing

authority, the date of the application, and the result thereof].

- OR -

I attest that, since the entry of the order of discipline, I have not applied for any licenses that

required proof of good character.

29.

Since my admission to the New York State Bar, I have had the following licenses

suspended or revoked: [state the nature of the license, the name of the licensing authority, the

date and reason for the action, and whether the license was revoked or suspended].

- OR -

I attest that, since my admission to the New York State Bar, I have not had any licenses

suspended or revoked.

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