Petition Form (Page 2 of 2) in pdf

Petition Form Page 2

Form 7-9

Page 2

__________________________________

Title

Signature of Attorney, if any

Attorney’s Address and Telephone Number

VERIFICATION (Individual)

STATE OF NEW YORK

)

) ss.:

COUNTY OF_____________________ )

_____________________________________________, being duly sworn,

deposes and says:

That (s)he is the__________________________________________________ in the above-entitled

proceeding and is acquainted with the facts and circumstances therein; that (s)he has read the foregoing and knows

the contents thereof; that the same is true to (his) (her) own knowledge, except as to matters therein stated to be

alleged on information and belief and as to those matters (s)he believes it to be true.

_____________________________

Sworn to before me this

_____ day of _____________, _____ .

(Deputy) (Clerk of the Court)

(Notary Public)

VERIFICATION (Agency)

STATE OF NEW YORK

)

) ss.:

COUNTY OF_______________________ )

_________________________________________, being duly sworn,

deposes and says:

That (s)he is the______________________________ of ____________________, an agency

authorized to originate the above- entitled proceeding, and is acquainted with the facts and circumstances therein;

that (s)he has read the foregoing and knows the contents thereof; that the same is true to (his) (her) own knowledge,

except as to matters therein stated to be alleged on information and belief and as to those matters (s)he believes it to

be true.

_____________________________

Name

_____________________________

Title

Sworn to before me this

_____ day of _____________

________________________

Notary Public

Petition Form Page 2