Form 4 - Order To Show Cause In A Special Proceeding Page 2

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Verification
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[25. Index No. & Year] Insert Index Number & the year it was purchased
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[26. Fill in name(s)] Fill in the Petitioner name
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[27. Fill in name(s)] Fill in the Respondent name
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[28. Insert County where papers signed and notarized] State County
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[29. Your name(s)] Your name
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[30. Insert Petitioner or Respondent] Fill in your position, either petitioner or
respondent.
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[31. Insert the name(s) of the above documents e.g. affidavit, petition etc.]
Insert the name of the document you have signed
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[32. SIGN YOUR NAME BEFORE NOTARY] Sign only before a notary public
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[33. PRINT YOUR NAME] Your name
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[34. Verification must be notarized] Document must be signed and notarized
Litigation Back (Last page of entire packet)
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[35. Index No. & Year] Insert Index Number & the year it was purchased
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[36. Fill in name(s)] Fill in the Petitioner name
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[37. Fill in name(s)] Fill in the Respondent name
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[38. Insert name(s) of papers submitted] Put the Names of all of the
documents
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[39. YOUR SIGNATURE] Signature
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[40. PRINT YOUR NAME] Your name
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[41. YOUR ADDRESS] Your address
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[42. CITY, STATE ZIP CODE] City State and Zip Code
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[43. YOUR PHONE NUMBER] Your telephone Number

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