STATE OF NEW YORK
DEPARTMENT OF STATE
____________
In the Matter of the Petition of:
(Name of Petitioner)
For a Declaratory Ruling.
____________
State of New York)
) SS.:
County of)
I, (Name of Petitioner), being duly sworn, deposes and says:
(Here identify and show the interest of petitioner.)
N.Y. Comp. Codes R. & Regs. Tit. 19 § 264.2