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Form 5 - Order To Show Cause In A Special Proceeding With Temporary Restraining Order (T.r.o.) Page 2

Verification

[24. Index No. & Year] Insert Index Number & the year it was purchased

[25. Fill in name(s)] Fill in the Petitioner name

[26. Fill in name(s)] Fill in the Respondent name

[27. Insert County where papers signed and notarized] State County

[28. Your name(s)] Your name

[29. Insert Petitioner or Respondent] Fill in your position, either petitioner or

respondent.

[30. Insert the name(s) of the above documents e.g. affidavit, petition etc.]

Insert the name of the document you have signed

[31. SIGN YOUR NAME BEFORE NOTARY] Sign only before a notary public

[32. PRINT YOUR NAME] Your name

[33. Verification must be notarized] Document must be signed and notarized

Litigation Back (Last page of entire packet)

[34. Index No. & Year] Insert Index Number & the year it was purchased

[35. Fill in name(s)] Fill in the Petitioner name

[36. Fill in name(s)] Fill in the Respondent name

[37. Insert name(s) of papers submitted] Put the Names of all of the

documents

[38. YOUR SIGNATURE] Signature

[39. PRINT YOUR NAME] Your name

[40. YOUR ADDRESS] Your address

[41. CITY, STATE ZIP CODE] City State and Zip Code

[42. YOUR PHONE NUMBER] Your telephone Number

Form 5 - Order To Show Cause In A Special Proceeding With Temporary Restraining Order (T.r.o.) Page 2