COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. APPLICATION FOR DIS POS S ES S ORY WARRANT : Plaintiff(s) JUDICIAL SUBPOENA PLEASE PRINT : Legal name of titleholder of-against- laintiff)________________________________________________________________ premises (P 1. Applicant (if different from 1.)_____________________________________________________________________________ : Authority to execute affidavit: ( ) Attorney at Law ( ) Attorney in Fact ( ) Agent 2. 3. ... Defendant(s) 4. 5. 6. : Leased premises: _____________________________________________________________ _______________________ Street Address Apartment Number Defendant(s) ___________________________________________ ________________ _______________________ : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State . City Zip 1.__________________________________________ 2.________________________________________ Type of Tenancy: _______________At Will _______________At Sufferance _______________Written Lease THE PEOPLE OF THE STATE OF NEW YORK TO Reason for Eviction: ____________Failure to pay rent ____________ Term expired __________Breach of Lease (Explain here)__________________________________________________________________________________________ ______________________________________________________________________________________________________ 7. GREETINGS: If tenancy at will, was tenant given 60 days notice to vacate? __________Yes __________No WE or termination, YOU, that all business and excuses __________Yes __________No of you attend before After breachCOMMAND was possession demanded immediately? being laid aside, you and each_________Excused , the Honorable at the Court 9. County of agreement, does it provide both parties may collect attorney fees? __________Yes __________No If written located at , on the day to , 20 , at o'clock in the noon, and at any recessed 10. in room has notice been sent of intention of enforce? If yes __________Yes __________No or adjourned date, to testify and give evidence as a witness in this action on the part of the 8. 11. If yes what is the measure of fees? __________Reasonable 12. _________Fixed Amount (give percentage __________) Mailing address for notices to P laintiff: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the _______________________________________________________________________________________________ as a party Address behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained on whose Apartment Number Street result of your failure to comply. ____________________________________ ___________ City State ______________ Zip _______________________ Daytime Telephone Witness, Honorable , one of the Justices of the County, day of , 20 Amount per Month _______________________________ Rent 13. Court inDue Date__________________________________________ 15. Amount Now Due________________________________________ would pay through________________________________ 16. Earliest date for which any rent is past due____________________________________________________________________ (Attorney must sign above and type name below) 17. Late charge past due___________________________ Interest rate on past due rent per agreement _______________% 18. Has P laintiff filed a dispossessory proceeding against this Defendant Attorney(s) for in the past 12 months? __________Yes __________No 19. Other possible addresses to serve Defendant(s) (P referably employment) (1)____________________________________________________ (2)____________________________________________ Office and P.O. Address ____________________________________________ ____________________________________________________ 20. What type of service do you want? ______________________P ersonal ** A case tacked is for possession only; no money can be awarded ___________________________Tacked to Door** Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com