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Affidavit of Compliance with the Insurance Law

If an affiant wishes to prove their compliance with the insurance law, he/she has to execute this affidavit.

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CIVIL COURT OF THE CITY OF NEW YORK

Index No.:

County of

AFFIDAVIT OF COMPLIANCE
WITH THE INSURANCE LAW

State of New York, County of 
ss:

, being duly sworn, deposes and says:

I am over 18 years of age and I am the Claimant in this action.

On 
I complied with ยง 1213 of the Insurance Law of the

State of New York in that I 1. served the Superintendent of the State Insurance Department with the original

Summons in this matter along with payment of the required fee, and I also

2. mailed Notice of this action to the Defendant, along with a copy of the Summons in

the matter, by Certified Mail, Return Receipt Requested.
Proof of such mailing to the Defendant is documented by:The signed and dated Return Receipt form which is annexed herewith.
The original envelope annexed herewith, bearing the notation by the Postal Service
that the mail was refused by the Defendant.
Signature of Deponent
Print Name of Deponent

day of

Sworn to before me this
Notary Public

CIV-GP-74-B(Revised 1104)-i 
20
FREE CIVIL COURT FORM
No fee may be charged to fill in this form.
Form can be found at: http://www.nycourts.gov/courts/nyc/civil/forms.shtml.
Relevant article from our knowledge database

There are a number of distinct types of affidavits. They must be filed by September 15 of each year. Before continuing to learn how to compose an affidavit letter, it is necessary to comprehend what an affidavit is.
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