COURT COUNTY OF ...................................................... : : Plaintiff(s) -against- : : : Index No. Calendar No. REQUEST FOR PRELIMINARY CONFERENCE : Defendant(s) : ...................................................... Name of assigned judge (If judge is not yet assigned, file this request with a request for judicial intervention) The undersigned requests a preliminary conference pursuant to 22 NYCRR 202.12(a).* Nature of action: Names, addresses and telephone numbers of all attorneys appearing in the action: Attorney(s) for Attorney(s) for Office and P.O. Address Office and P.O. Address Telephone No.: Telephone No.: Attorney(s) for Attorney(s) for Office and P.O. Address Office and P.O. Address Telephone No.: Telephone No.: Dated: (Attorney(s) - sign above/type name below) Attorney(s) for Office and P.O. Address Telephone No.: * NOTE: Annex Affirmation of Good Faith American LegalNet, Inc. www.FormsWorkFlow.com