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Notice Of Service On An Unauthorized Insurer CIV-GP-74-A - New York

Notice Of Service On An Unauthorized Insurer Form. This is a New York form and can be used in Civil Court New York Local County .
 Fillable pdf Last Modified 11/3/2005
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CIVIL COURT OF THE CITY OF NEW YORK NOTICE OF SERVICE ON AN UNAUTHORIZED INSURER (TO BE SENT BY CERTIFIED MAIL) TO: RE - Index No.: In accordance with 1213 of the Insurance Law of the State of New Yo rk, notice is hereby given to you that I have served the Superintendent of the New Yor k State Insurance Department, as your true and lawful attorney, with a Summons naming you as Defendant in an action. A copy of the Summons referred to is enclosed herewith. Signature Policy Number Print Name CIV-GP-74-A(Revised 1104)-i American LegalNet, Inc. www.USCourtForms.com
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