Petition - New York Supreme Court (Page 4 of 5) in pdf

Petition - New York Supreme Court Page 4

[Fill in the spaces next to the instructions.]

SUPREME COURT OF THE STATE OF NEW YORK

COUNTY OF NASSAU

----------------------------------------------------------------------------x

In the Matter of the Application of

[17. Index No. & Year]

___________________________________________,

Index No.

[18. Fill in name(s)]

Petitioner(s)

___________ /

VERIFICATION

-against-

____________________________________________,

[19. Fill in name(s)]

Respondent(s)

-----------------------------------------------------------------------------x

STATE OF NEW YORK}

SS. :}

COUNTY OF ____________}

[20. Insert County where papers signed and notarized]

_______________________________[21. Insert Your Name] , being duly sworn,

deposes and says: I am the__________________________ [22. Insert Petitioner or

Respondent] in this matter. I have read the foregoing __________________ [23. 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

_________________________________

[24. SIGN YOUR NAME BEFORE NOTARY]

_________________________________

[25. PRINT YOUR NAME]

Sworn to before me this

day of ______________, 20 __

___________________________

Notary Public

[26. Verification must be notarized]

Petition - New York Supreme Court Page 4