Emergency Affidavit - New York Supreme Court

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[Fill in the spaces next to the instructions. Attach copies of the indicated
documents and mark them as exhibits. Sign your name in the presence of a
notary public]
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
----------------------------------------------------------------------------x
[1. Index No. & Year]
,
Index No.
[2. Fill in name(s)]
Plaintiff(s)/Petitioner(s)
/
EMERGENCY AFFIDAVIT
-against-
,
[3. Fill in name(s)]
Defendant(s)/Respondent(s)
-----------------------------------------------------------------------------x
STATE OF NEW YORK,
COUNTY OF NASSAU ss:
I, [4. Your name]
, am the [5. Circle One]
plaintiff/petitioner/defendant/respondent in the above action/special proceeding. I
request immediate judicial review of my
[6. List the document you are presenting]
on the following grounds [7. Describe the reasons you need immediate relief, not the
merits of your underlying case]
[8. Sign your name before a Notary Public]
Sworn to before me this
day of
, 20
[9. Print Your Name]
Notary Public [10. Affidavit must be notarized]

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