NOTE OF ISSUE
Claim No. ________
New York State Court of Claims, ________ District
Notice for trial
Filed by attorney for ____________
Date claim filed ____________
Date claim served ____________
Date issue joined ____________
Nature of action
Tort: Highway or motor vehicle negligence ________
Medical malpractice ________
Other tort (specify) ____________
Appropriation claim ________
Small claim pursuant to article 6 EDPL ________
Public construction contract claim ________
Other contract ________
Other type of action (specify) ________
_____________________________
Amount demanded $ ________
Other relief
Attorney(s) for Claimants(s)
Office and P.O. Address:
Phone No.
Attorney(s) for Defendant(s) Insurance carrier(s): __________________
Office and P.O. Address:
Phone No.
Note: Clerk will not accept this note of issue unless accompanied by a certificate of readiness.
CERTIFICATE OF READINESS FOR TRIAL
(Items 1-6 must be checked)
Not _______________________________
Complete Waived required _________________________________
Dated: ____________
(Signature) ____________
Attorney(s) for: ____________
Office and P.O. address: ____________
_______________________________
N.Y. Comp. Codes R. & Regs. Tit. 22 § 206.12