Application For Index Number

MAUREEN O'CONNELL Nassau County Clerk APPLICATION FOR INDEX NUMBER PURSUANT TO SECTION 8018 (A) CIVIL PRACTICE LAW AND RULES INDEX NUMBER SUPREME COURT: NASSAU COUNTY FULL TITLE OF ACTION OR PROCEEDING (Please type or print) Plaintiff/Petitioner vs. Defendant/Respondent Third Party (If applicable) Application for Index Number filed by: Plaintiff Defendant Type of Action: Asbestos Civil Forfeiture (Mandatory E-File) Commercial (Mandatory E-File) Commercial Credit (Card) Transaction Original Buyer Plaintiff Debt Buyer Plaintiff Secondary Debt Buyer Plaintiff Consumer Credit (Non-Card) Transaction Contract Commercial (Mandatory E-File) Non-Commercial For Plaintiff/Petitioner: Guardianship (Article 81) Matrimonial Contested Uncontested Mortgage Foreclosure Name Change Tax Certiorari (Mandatory E-File) Tax Lien Foreclosure (Mandatory E-File) Tort Medical Malpractice Other (i.e. Personal Injury/Motor Vehicle) Other (must indicate) For Defendant/Respondent: Name Name Address Address Town and Zip code Town and Zip code Telephone Number Telephone Number If you would like a receipt mailed to you, please provide a self -addressed stamped envelope Rev. 11/2014 American LegalNet, Inc. www.FormsWorkFlow.com