NEW YORK COUNTY SUPREME COURT - SPECIAL REFEREE CALENDAR (PART SRP) INFORMATION SHEET Title of Action: Index No.: Issues Referred: IMPORTANT: IN ORDER THAT THIS MATTER MAY BE ASSIGNED EFFICIENTLY TO A JUDICIAL HEARING OFFICER/SPECIAL REFEREE, ALL COUNSEL MUST CONSULT ONE ANOTHER AND PROVIDE THE FOLLOWING ESSENTIAL INFORMATION AS ACCURATELY AS POSSIBLE: Estimated Time Needed for Entire Hearing: Number of Witness to be Called by All Counsel: Attorney for Plaintiff/Petitioner: Address: (City) Phone: Fax: Attorney for Defendant/Respondent Address: (City) Phone: Fax: Please submit this form (one per case, with additional pages if needed to identify other counsel), as soon as possible after issuance of the Order of Reference and in any event within 15 days of the date of that Order, to: Special Referee Clerk - Motion Support Office 60 Centre Street - Room 119, New York, New York 10007 - - This form must be sent to the Special Referee Clerk by fax (212) 401-9186 or e-mail (spref@courts.state.ny.us). - - You will be notified of the date and time of the hearing. - - Please direct all inquiries to the Special Referee Clerk by phone (646-386-3028) or e-mail (address above). - - Cases are assigned to a Judicial H earing Officer/Special Referee and the hearing commences on the original hearing date. Counsel therefore must appear with witnesses and evidence, and be prepared to proceed, on the original date. See the Rules of the Special Referees Part for information about adjournments (which are limited) and other relevant matters. 9/14/09 (State) E-Mail: (Zip) (State) E-Mail: (Zip) American LegalNet, Inc. www.FormsWorkFlow.com