Summons With Notice - New York Supreme Court

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[Fill in the spaces next to the instructions. Other spaces are for Court use.]
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)
/
SUMMONS WITH
-against-
NOTICE
,
[3. Fill in name(s)]
Defendant(s)
-----------------------------------------------------------------------------x
To the Person (s) Named as Defendant(s) above:
PLEASE TAKE NOTICE THAT YOU ARE HEREBY SUMMONED to appear in this
action by serving a notice of appearance on the plaintiff(s) at the address set forth below,
and to do so within twenty (20) days after the service of this Summons, or within thirty(30)
days after service is complete if the Summons is not delivered personally to you within the
State of New York.
YOU ARE HEREBY NOTIFIED THAT should you fail to answer or appear, a
judgment will be entered against you by default for the relief demanded below.
[4. Date and County papers are signed in]
Dated:
County:
[5. Your Signature]
[6. Your Name]
[7. Your Address]
[8. City, State & Zip Code
To the Defendant:
[9. Your Phone Number]
[10. Defendant Address]
[11. City, State Zip Code]
[12. Phone Number]

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