Verification - New York Supreme Court

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[Fill in the spaces next to the instructions.]
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
----------------------------------------------------------------------------x
[ Index No. & Year]
___________________________________________,
Index No.
[ Fill in name(s)]
Plaintiffs/Petitioner(s)
___________ /
VERIFICATION
-against-
____________________________________________,
[ Fill in name(s)]
Defendants/Respondent(s)
-----------------------------------------------------------------------------x
STATE OF NEW YORK}
SS. :}
COUNTY OF ____________}
[Insert County where papers signed and notarized]
I, _______________________________[ Insert Your Name] , being duly
sworn, deposes and says: I am the__________________________ [Insert Plaintiff or
Petitioner] in this matter. I have read the foregoing __________________ [Insert the
name(s) of the above documents e.g. affidavit, petition etc.] and know the contents
thereof. The same are true to my knowledge, except as to matters therein stated to be
alleged on information and belief and as to those matters I believe them to be true
[SIGN YOUR NAME BEFORE NOTARY]
[ PRINT YOUR NAME]
Sworn to before me this
day of ______________, 20 __
___________________________
Notary Public
[Verification must be notarized]

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