Note of Issue
Calendar No. _____________
Index No. ________________ ________________________ County
________________________________
Name of Assigned Judge
Trial by jury demanded
... of all issues
... of issues specified below
... or attached hereto
Trial without jury
Filed by attorney for __________________
Date summons served __________________
Date service completed __________________
Date issue joined __________________
Nature of action of special proceeding
Tort:
Motor vehicle negligence...
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