NOTICE OF TRIAL OR INQUEST Calendar No. (if any)COURT Index No. COUNTY OF : : : Index No. : : : UPON APPLICATION FOR .......................................... For use of clerk CIVIL COURT OF THE CITY OF NEW YORK COUNTY OF ................................................ : -againstPlaintiff(s) ...................................................... : : : : : : : : : : : : AFFIDAVIT OF FACTS DEFAULT JUDGMENT Trial by jury demanded of all issues of issues specified below or attached hereto Trial without jury Filed by attorney(s) for Date summons served Date service completed Date issue joined (Constituting Claim, Default and Amount Due) Defendant(s) : : ...................................................... STATE OF NEW YORK COUNTY OF -against- ) ) ) Plaintiff(s) ss.: : : : : being duly sworn, deposes and says: 1. 2. 3. 4. : I am the plaintiff in the above captioned action, and I submit this affidavit in support of the instant application for judgment by default pursuant to CPLR § 3215. Tort: : : : This is an action for Nature of Action or Special Proceeding Motor Vehicle Negligence Medical Malpractice Other tort This action was commenced on or about by Contract service of a summons and upon the defendant(s) herein. : Other (not itemized above) has expired, and the Defendant(s) : (specify) The time for the defendant(s) to answer or move with respect to the . . . . . . . . . . . . . . . . .defendant(s). has/have. not .answered.or.moved with respect to the ........ ...... .. ...... . ... Indicate if this action is brought 5. The defendant(s) Special Preference claimed under time to plead has not been extended, and the defendant(s) is/are now in default in pleading. as a class action 6. Pursuant to CPLR § 3215(f)(3), additional notice of the default was duly given by * at least 20 Amount demanded $ on the ground that days before the entry of such judgment, by mailing a copy of the summons by first-class mail to the defendant at the defendant's place of residence in an envelope bearing Other relief the legend ''personal and confidential'' and not indicating on the outside of the envelope that the communication was from an attorney or concerns an alleged debt. ** Insurance carrier(s), if known: 7. *** Proof of service of the said additional notice is annexed hereto. Attorney(s) WHEREFORE, deponent demands judgment against the defendant(s) in the sum of $ for Plaintiff(s) Attorney(s) for Defendant(s) with interest from Dated: together with the costs and disbursements of this action. Office and P.O. Address Sworn to before me on Office and(Plaintiff must sign above and type name below) P.O. Address Telephone No.: Notary Public * ** Insert ''me'' or ''my attorney(s)'', as the case may be. Insert any other information concerning circumstances of mailing - See CPLR § 3215(f)(3)(i) must be executed by person mailing the notice and filed with the judgment. Telephone No.: Note: The clerk will not accept this Note of Issue unless accompanied by3215(f)(3)(ii), the affidavit of mailing of additional notice *** Pursuant to CPLR § a Certificate of Readiness. 2003 © American LegalNet, Inc. American LegalNet, Inc. www.USCourtForms.com www.USCourtForms.com CERTIFICATE OF READINESS FOR TRIAL (Items 1-5 must be checked) COURT COUNTY OF ...................................................... : : : : : Complete Waived Not Required 1. 2. 3. 4. 5. 6. 7. All pleadings served ............................................................... Index No. Bill of Particulars served ........................................................ Physical examinations completed ........................................... AFFIDAVIT OF FACTS -againstPlaintiff(s) UPON APPLICATION FOR Medical reports exchanged ..................................................... DEFAULT JUDGMENT (Constituting Claim, Default and Amount Due) Discovery proceedings now known to be necessary : completed ................................................................................ There are no outstanding requests for discovery. : Defendant(s) : . . . . . . . . . has .been . . reasonable. opportunity. to. complete. the. foregoing proceedings. There . . . . . . . a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STATE OF NEW YORK ) ) ) ss.: 8. The case is ready for trial. COUNTY OF Dated: 1. 2. 3. 4. 5. 6. being duly sworn, deposes and says: I am the plaintiff in the above captioned action, and I submit this affidavit in support of the instant application for judgment by default pursuant to CPLR § 3215. This is an action for (Attorney must sign above and type name below) This action was commenced on or about by service of a summons and upon the defendant(s) herein. Attorney(s) for: The time for the defendant(s) to answer or move with respect to the defendant(s) has/have not answered or moved with respect to the has expired, and the The defendant(s) time to plead has not been extended, and the defendant(s) is/are now in default in pleading. Pursuant to CPLR § 3215(f)(3), additional notice of the default was duly given by * at least 20 Office and Post Office Address days before the entry of such judgment, by mailing a copy of the summons by first-class mail to the defendant at the defendant's place of residence in an envelope bearing the legend ''personal and confidential'' and not indicating on the outside of the envelope that the communication was from an attorney or concerns an alleged debt. ** Telephone No.: 7. *** Proof of service of the said additional notice is annexed hereto. WHEREFORE, deponent demands judgment against the defendant(s) in the sum of $ with interest from together with the costs and disbursements of this action. Dated: Sworn to before me on (Plaintiff must sign above and type name below) * Notary Public ** *** Insert ''me'' or ''my attorney(s)'', as the case may be. Insert any other information concerning circumstances of mailing - See CPLR § 3215(f)(3)(i) Pursuant to CPLR § 3215(f)(3)(ii), the affidavit of mailing of additional notice must be executed by person mailing the notice and filed with the judgment. 2003 © American LegalNet, Inc. American LegalNet, Inc. www.USCourtForms.com www.USCourtForms.com