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SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF

STATEMENT OF AUTHORIZATION FOR
ELECTRONIC FILING
(Single Attorney Authorizing Filing Agent Entity)

I, , Esq., ( Attorney Registration No. ) am an authorized user of the New York State Courts Electronic Filing System (“NYSCEF”) (User ID ). I hereby authorize any employee of “Servico, Inc.” who possesses a NYSCEF filing agent ID to file documents on my behalf and at my direction, as a filing agent, in any e-filed matter in which I am counsel of record through the NYSCEF system, as provided in Section 202.5-b of the Uniform Rules for the Trial Courts.

This authorization extends to any consensual matter in which I have previously consented to e-filing, to any mandatory matter in which I have recorded my representation, and to any matter in which I may authorize the filing agent to record my consent or representation in the NYSCEF system.

This authorization extends to any and all documents I generate and submit to the filing agent for filing in any such matter. This authorization, posted once on the NYSCEF website as to each matter in which I am counsel of record, shall be deemed to accompany any document filed in that matter by the filing agent.

This authorization also extends to matters of payment, which the filing agent may make either by debiting an account the filing agent maintains with the County Clerk of any authorized e-filing county or by debiting an account I maintain with the County Clerk of any authorized e-filing county.

This authorization regarding this filing agent shall continue until I revoke it in writing on a prescribed form delivered to the E-Filing Resource Center.

Dated

Signature

City

State

Zip Code

Print Name

Phone

Firm/Department

E-Mail Address

Street Address

Special Instructions

contact information:

Your Name

Your Firm

Email

Your Phone

Your Fax

How would you like to be contacted

Billing information:

Address

City

state

zip

Costs vary with information published, location and newspaper designated. A Servico representative will contact you with total cost once submitted.

Credit Card Information:

Card Holder Name

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Expiration

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