Certification - New York Supreme Court
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1SUPREME 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)
/
CERTIFICATION
-against-
PURSUANT TO
22 NYCRR 130-1.1-a
,
[3. Fill in name(s)]
Defendant(s)/Respondent(s)
-----------------------------------------------------------------------------x
I hereby certify that all of the papers that I have served, filed or submitted to the court in this
action/proceedings (as indicated by the check marks below) are not frivolous as defined in
subsection c of Section 130-1.1 of the Rules of the Chief Administrator of the Courts.
G
G
Note of Issue
Defendant’s Affidavit
G
G
Poor Person Order
Petition
G
G
Order permitting alternative service
Consent of Infant
G
G
Summons or Summons with Notice
Consent of Spouse
G
G
Verified Complaint
Emergency Affidavit
G
G
Affidavit of Service or Defendant’s
Affidavit in Support of TRO against
Waiver
public officers, etc.
G
G
Notice of Appearance
Decision
G
G
Affidavit or Affirmation of Regularity
Judgment
G
G
Affidavit of Military Status or
Reply Affidavit
G
Investigator
Notice of Entry
G
G
Plaintiff’s Affidavit
Other
G
Affidavit of Witness
G
Exhibits
[4. Date] Dated:
[5. Plaintiff Signature]
[6. Print Name]
Duly Sworn to before me this
____ day of _____________, 20___
[7. Notary Public]
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