Client Verification (Individual)

STATE OF NEW YORK

SS.:

COUNTY OF __________

__________ [Name], being duly sworn, deposes and says:

I am the [plaintiff/defendant] in the within action; I have read the foregoing verified [Title of pleading] and know the contents thereof and the same is true to my own knowledge except as those matters alleged to be upon information and belief, and that as to those matters, I believe them to be true.

___________________________

[Name]

Sworn to before me this

____ day of...