SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
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[24. Index No. & Year]
,
Index No.
[25. Fill in name(s)]
Plaintiff(s)
/
-against-
,
[26. Fill in name(s)]
Defendant(s)
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______________________________________________________________________
[27. Insert name(s) of papers submitted]
[28. YOUR SIGNATURE]
[29. PRINT YOUR NAME]
[30. YOUR ADDRESS]
[31. CITY, STATE ZIP CODE]
[32. YOUR PHONE NUMBER]