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APPLICATION FOR INDEX NUMBER FEE $210.00 Pursuant to CPLR 306-a STATE OF NEW YORK County Clerk FULL TITLE OF ACTION OR PROCEEDING (Please type or print.) Index Number Do Not Write In This Space Court, County Plaintiff(s)/Petitioner(s) vs. Defendant(s)/Respondent(s) Name and address of Attorney for Plaintiff(s)/ Petitioner(s). * * Your name and address if you are representing yourself. Name and address of Attorney for Defendant(s)/ Respondent(s). Indexed and Entered Do not write on line above. DO NOT DETACH FULL TITLE OF ACTION OR PROCEEDING (Please type or print.) INDEX NUMBER FEE $210.00 Endorse this Index Number on ALL papers and advise your adversary of the number assigned. Court, County COMPLETE THIS STUB Plaintiff(s)/Petitioner(s) vs. Defendant(s)/Respondent(s) American LegalNet, Inc. www.FormsWorkFlow.com