Address Confidentiality Affirmation {GF-21}

General Form 21 - ADDRESS CONFIDENTIALITY AFFIRMATION. This form is used in the Family Court of the State of New York. It is typically filed in cases where the petitioner or respondent is seeking to keep their address confidential. The form includes sections for the individual's name (petitioner or respondent), the reason for seeking address confidentiality, and relevant details such as participation in a domestic violence shelter, possession of an address confidentiality order, or enrollment in the Address Confidentiality Program of the NYS Department of State. Additionally, the form requires the designation of a person as an agent for service of process and an agreement to promptly inform them of any address changes. The document must be affirmed under the penalties of perjury, and there is a section for the signature of the individual and their attorney (if applicable). DRL §§76-h (5), 254; Exec. L. §108; FCA §§ 154-b; 818; 1015. www.FormsWorkflow.com