COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : APPLICATION FOR PERSONAL PROPERTY FORECLOSURE Index No. PLEASE PRINT 1. Type of claim: 2. : ( ) Security Interest ( Calendar No. ) Rental/Leased Personal Property ( : Plaintiff(s) JUDICIAL SUBPOENA Legal name of Person/Corporation having title or security interest in collateral: -against- ) Title Retention : (Plaintiff)______________________________________________________________________________________ : 3. Applicant/Affiant (if different from #2)_______________________________________________________________ : Defendant(s) Authority to execute affidavit: ( ) Attorney at Law ( ) Attorney in Fact : ...................................................... 4. ( ) Agent Person(s) with possession of collateral: (Defendant name)_______________________________________________ __________________________________________ ______________________ ____________ ____________ State Zip THE PEOPLE OF THE STATE OF NEW YORK Street City 5. TO Location of collateral (if different from #4)____________________________________________________________ 6. Form of Indebtedness (attach copy) ( ) Promissory Note ( ) Written Agreement ( ) Installment Contract ( ) Conditional Sale Contract ( ) Rental/Lease Agreement ( ) Sale with Title Retention GREETINGS: 7. 8. Description of collateral (BE SPECIFIC, include serial number, model numb etc.)____________________________ ______________________________________________________________________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court Defaultof( ) Failure to pay installments, due dates of unpaid installments_________________________________ located at County in room ( ) Other ,____________________________________________________________________________ at any recessed on the day of , 20 , at o'clock in the noon, and __________________________________________________________________________________ or adjourned date, to testify and give evidence as a witness in this action on the part of the 9. Amounts Due: 10. Has the principal amount due been accelerated? 11. 12. Principal $__________________ Interest $____________________ Other $________________ ( )Yes ( )No Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Have you rebated unearned interest? ( )Yes ( )No ( )N/A result of your failure to comply. Are there future installments? ( )Yes ( )No Witness, Honorable , one of the Justices of If yes, number of installments to become due: _________________ Amount of each $________________________ Frequency: ( ) Monthly ( Due Court in County, ) Weekly of( ) Bi-weekly , 20 day/date ___________________________ day the 13. Does agreement provide for collection of attorney fees? ( )Yes ( )No If yes, have you sent notification of intent to enforce? ( )Yes ( )No If yes, what is measure of fees: ( )Reasonable ( )10% ( )15% (Attorney must sign above and type name below) 14. Mailing address for notices to Plaintiff: Attorney(s) for _______________________________________________________________________ Street Address _______________________________________________ City 15. Other possible addresses to serve Defendant(s): (1)_______________________________________________ _______________________________________________ __________ State _________________ Apartment number ___________ _________________ Office and P.O. Address Zip Daytime Telephone (Preferable employment) Telephone No.: Facsimile No.: (2)_____________________________________________ E-Mail Address: _____________________________________________ Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com