SPECIAL TERM NOTE OF ISSUE (This part to be typed out by party making motion and filed with the Clerk of Special Term pursuant to Rule XVIII) SUPREME COURT: ERIE COUNTY Dated: ................................................ Index No: .......................................... ............................................................................ ...........................................................Plaintiff, -vs............................................................................... ..............................................................Defendant, Motion made by: ................................................... ....................................................................... Attorney Phone: ........................................................... ....................................................................... Attorney Phone: ........................................................... Am Returnable: ....................................... Pm Relief Sought: .................................................................................................................................. Special Term Clerk’s Use Only: Note of Issue Received ......................................................................... Adjourned to: .................................................20 ..... at ....................M. .................................................20..... at .....................M. ..................................................20.... at .....................M. Papers obtained from counsel and submitted to court at time of argument: In support of Motion: Against Motion: ........................................................................ ....................................................................... ....................................................................... Notes made at Justice’s Direction: ....................................................................... FOR JUSTICES USE ONLY: DECISION: Date:..................................................................... ....................................................................... American LegalNet, Inc. www.FormsWorkflow.com