Petition For Withdrawal Of An Infant'S Funds - New York Supreme Court Page 4

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[Fill in the spaces next to the instructions.]
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
----------------------------------------------------------------------------x
[29. Index No. & Year]
___________________________________________,
Index No.
[30. Fill in name(s)]
Plaintiff(s)
___________ /
VERIFICATION
-against-
____________________________________________,
[31. Fill in name(s)]
Defendants(s)
-----------------------------------------------------------------------------x
STATE OF NEW YORK}
SS. :}
COUNTY OF ____________}
[32. Insert County where papers signed and notarized]
_______________________________[33. Insert Your Name] , being duly sworn,
deposes and says: I am the__________________________ [34. Insert Petitioner or
Respondent] in this matter.
I have read the foregoing [35. 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
[36. SIGN YOUR NAME BEFORE NOTARY]
[37. PRINT YOUR NAME]
Sworn to before me this
day of ______________, 20 __
Notary Public
[38. Verification must be notarized]

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