New York > Appellate Courts > Appellate Division > 2nd Department

Affirmation - New York

Affirmation Form. This is a New York form and can be used in 2nd Department Appellate Division Appellate Courts .
 Fillable pdf Last Modified 11/5/2003
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Supreme Court of the State of New York Appellate Division: Second Judicial Department AFFIRMATION Appellate Division Docket No.: ________________________ State of New York ) County of _______________ ) ss.: I, ____________________________________, affirm under the penalties of perjury that: 1. 2. 3. 4. 5. WHEREFORE, I request that the court grant me the following relief: Dated: ________________ ____, 200__ ____________________________________ Affirmed before me this _____ day of _____________, 200__ ___________________________________ Notary Public 2002 © American LegalNet, Inc.
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