NOTE OF ISSUE
Calendar No. (if any) ________ For use of clerk
Index No. ________
________ Court, ________ County
Name of assigned judge ............
Notice for trial
Trial by jury demanded ________
________ of all issues
________ of issues specified below
________ or attached hereto
Trial without jury ________
Filed by attorney for ____________
Date summons served ____________
Date service completed ____________
Date issue joined ____________
Nature of action or special proceeding
Tort:
Motor vehicle negligence ________
Medical malpractice ________
Other tort ________
Contract ________
Contested matrimonial ________
Uncontested matrimonial ________
Special preference claimed Tax certiorari ________
under ________ Condemnation ________
on the ground that ________ Other (not itemized above) ________
________ (specify)
Attorney(s) for Plaintiff(s) Indicate if this action is
Office and P.O. Address: brought as a class action ________
Phone No.
Attorney(s) for Defendant(s)
Office and P.O. Address:
Phone No. Amount demanded $ ____________
Other relief ____________
Insurance carrier(s), if known:
NOTE: The clerk will not accept this note of issue unless accompanied by a certificate of readiness.
CERTIFICATE OF READINESS FOR TRIAL
(Items 1-7 must be checked)
Not
Complete Waived required
202.16 of the Rules of the
Chief Administrator (22 NYCRR
202.16) in matrimonial actions. ________ ________ ________
of the Rules of the Chief
Administrator (22 NYCRR
202.12).
202.56 of the Rules of the
Chief Administrator (22 NYCRR
202.56).
Dated: ________
(Signature) ________
Attorney(s) for: ________
Office and P.O. address: ________
________
N.Y. Comp. Codes R. & Regs. Tit. 22 § 202.21