Admission of Service

Document

Cited in

[Caption]

The undersigned admits service upon them of __________ [Titles of documents], dated __________ [Date], in connection with the above-captioned matter.

Dated: __________ [City], New York

__________ [Date]

_________________________

[Attorney’s name]

[Address]

[Telephone number]

Attorney for [Plaintiff/Defendant]

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Admission of Service

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