1 2 3 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF -------------------------------------------------------------------X Plaintiff, -againstIndex No.: SWORN STATEMENT OF REMOVAL OF BARRIERS TO REMARRIAGE 4 5 Defendant. -------------------------------------------------------------------X STATE OF } ss: COUNTY OF } (Print Name), state under penalty of perjury that the I parties* marriage was solemnized by a minister, clergyman or leader of the Society for Ethical Culture, and that; 6 ` To the best of my knowledge I have taken all steps solely within my power to remove all barriers to the Defendant' remarriage following the divorce. s OR ` The Defendant has waived in writing the requirements of DRL §253. 7 ____________________________________ Plaintiff' Signature s Subscribed and Sworn to before me on NOTARY PUBLIC (Form UD-4 - Rev. 5/99) 2001 © American LegalNet, Inc. Affidavit of Service SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF 1 2 _____________________________ being sworn, says, I am not a party to the action, and am over 18 years of age. I reside at _____________________________________________________. On _____________________, I served a true copy of the within Removal of Barriers Statement on the Defendant: ` ` personally at _____________________________________________________________ OR by depositing a true copy thereof enclosed in a post-paid wrapper, in an official depository under the exclusive care and custody of the U.S. Postal Service within New York State, to the address designated by the Defendant at 3 4 ______________________________ Server' Signature s Subscribed and Sworn to before me on _____________________ _________________________ NOTARY PUBLIC OR 5 Service of the within document is hereby acknowledged. ` Defendant' Signature OR s ` Defendant' Attorney' Signature s s (Form UD-4a - Rev. 5/99) 2001 © American LegalNet, Inc.