(b) Forms. The note of issue and certificate of readiness shall read substantially as follows:
NOTE OF ISSUE
Calendar No. (if any) ________ For use of clerk
Index No. ________
________ Court, ________ County
Name of assigned judge ............
Notice for trial
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 or special proceeding
Tort:
Motor vehicle negligence ________
Medical malpractice ________
Other tort ________
Contract ________
Contested matrimonial ________
Uncontested matrimonial ________
Special preference claimed Tax certiorari ________
under ________ Condemnation ________
on the ground that ________ Other (not itemized above) ________
________ (specify)
Attorney(s) for Plaintiff(s) Indicate if this action is
Office and P.O. Address: brought as a class action ________
Phone No.
Attorney(s) for Defendant(s)
Office and P.O. Address:
Phone No. Amount demanded $ ____________
Other relief ____________
Insurance carrier(s), if known:
NOTE: The clerk will not accept this note of issue unless accompanied by a certificate of readiness.
CERTIFICATE OF READINESS FOR TRIAL
(Items 1-7 must be checked)
Not
Complete Waived required
1. All pleadings served. ________ ________ ________
2. Bill of particulars served. ________ ________ ________
3. Physical examinations completed. ________ ________ ________
4. Medical reports exchanged. ________ ________ ________
5. Appraisal reports exchanged. ________ ________ ________
6. Compliance with section
202.16 of the Rules of the
Chief Administrator (22 NYCRR
202.16) in matrimonial actions. ________ ________ ________
7. Discovery proceedings now known to be necessary completed. ________ ________ ________
8. There are no outstanding requests for discovery.
9. There has been a reasonable opportunity to complete the foregoing proceedings.
10. There has been compliance with any order issued pursuant to section
202.12
of the Rules of the Chief
Administrator (22 NYCRR
202.12).
11. If a medical malpractice action, there has been compliance with any order issued pursuant to section
202.56 of the Rules of the
Chief Administrator (22 NYCRR
202.56).
12. The case is ready for trial.
Dated: ________
(Signature) ________
Attorney(s) for: ________
Office and P.O. address: ________
________