Blumberg-Law-Forms-Catalog.pdf

Blumberg Law Forms

Blumberg 800 LAW-MART (529-6278) www.blumberg.com

LEASES

Apartment Unregulated

A 186 Apartment lease, 2-5 units, furn/unfurn, plain English, 4 pp., 7-19

A 261 Replaced by revised form A186.

T 202 Lease from month to month, 7-19

303 Apartment lease, furn/unfurn, plain English, 4 pp., 7-19,Web Only

T 48 Apartment lease, balanced moderate coverage, plain English,

2 pp. , 6-21

A 55 Apartment lease, comprehensive, guaranty, acknowledgments,

plain English, 4pp., 7-19

M 57 Lease for an unregulated apartment, 13 pp., 8-21

Apartment Regulated

A 327 Apartment lease, stabilized/controlled, plain English, 2 pp., 7-19

A 53 Replaced by revised form A327

M 56 Lease for a rent stabilized apartment, 13 pp., 7-19

House

3120NY House lease with option to buy, plain English, furnished or

unfurnished, 7-19, Web Only

A 54 House lease, furn/unfurn, moderate coverage, plain English,

4 pp., 7-19

A 495 Replaced by revised form A54.

Condominium

101 Condominium unit lease, plain English, 8 pp., 7-19

102 Condominium unit lease, comprehensive, 11 pp., 7-19,

Web Only

Cooperative

86 Sublease of a cooperative apartment, 13 pp., 7-19, Web Only

Seasonal

315 Weekly vacation residence lease, plain English, furnished, 2 pp.,

7-19, Web Only

313 Seasonal/vacation lease, house/apartment, furnished, plain English,

2pps., 7-19

SUMMARY PROCEEDINGS FORMS

Notice to Tenants

B 119 Notice to tenant, 14 days, English and Spanish, assistance

statement, 7-19

T 304 Notice to tenant by certiﬁed mail, 5 days, English and Spanish,

assistance statement, 7-19

T 309 Omnibus notice of termination of tenancy of non-regulated residence,

30, 60 or 90 days, 7-19

Notice of Petition

T 207B Notice of petition, non-payment, business, Civil Ct., 7-19

T 207D Notice of petition, non-payment, dwelling, Civil Ct., 7-19

X 211 Notice of petition, holdover, dwelling, Civil Ct., 7-19

X 445 Notice of petition, non-payment, Blank Ct., 7-19

T 449 Notice of petition, holdover, Blank Ct., 7-19

T 511 Notice of petition, any grounds, Blank Ct., 7-19

T 1407 Notice of petition, non-payment, District Ct., 7-19, Web Only

T 1411 Notice of petition, dwelling or business, District Ct., 7-19, Web Only

Price Chart for Blumberg Forms

How to use this price chart: Select your forms. Note code letter preﬁxed to form number. Locate the corresponding column on the Price Chart. Quantities

and prices are listed accordingly. Bold face indicates the price of the full package. If a form does not have a price code, look up the catalog number in the

Numerical List. The price will follow the title of the form.

All prices subject to change without notice.

Revised: May 1, 2022

FOLDED INTO 4 PAGES SINGLE SHEETS: LETTER OR LEGAL SIZE

A-W-R M P B T-X C

QUANTITY COTTON PAPER

6 – – – – – $57.60

48 – – $63.35 $52.30 $60.48 –

24 $61.95 $65.25 – – – –

12 39.00 41.80 23.40 21.00 24.60 21.00

3 15.15 16.50 13.95 14.10 13.80 14.85

Housing Stability and Tenant Protection Act of 2019

All forms available at blumberglegalforms.com and on paper, except those marked “Web Only.”

Operating Agreements and Minutes & Bylaws

Operating Agreements for LLC’s

The Operating Agreements below in ﬁllable pdf format are included by default with LLC kits ordered with Operating Agreements*.

If you prefer paper versions please request them when you order the kit.

New York LLC Operating Agreements and Governance Documents

Prepared by Lauris G. L. Rall and Tim Santoli, Dentons US LLP. Revised in 2016.

A thorough and tax-sensitive set of documents to govern the LLC during its lifetime. Suitable for member and manager governed LLC’s.

• Commentary by the authors

• 1A–Member Managed Single Member Operating Agreement

• 1B–Manager Managed Single Member Operating Agreement

• 2A– Manager Managed Multiple Member Operating Agreement, Consent of Members, Consent of Managers and

Company Regulations

• 2B–Member Managed, Multiple Member Operating Agreement

— Fillable PDF with LLC name and state in appropriate ﬁelds, sent via email, Cat. No. 5154PDFZ, if purchased without a kit, $18.00*.

Comes with LLC kit if you order the Cat. No. with printed forms.

— Paper forms Cat. No. 5154, if purchased without a kit, $18.90. Comes with LLC kit if you order the Cat. No. with printed forms and specify

paper forms instead of ﬁllable pdf forms.

Model Operating Agreements for Any State

Prepared by Victor S. Elgort, Esq., Norris McLaughlin & Marcus, P. A. Revised in 2016. Six forms included plus a Comparative Features List to

help you choose the appropriate form:

a) Single member, member governed; b) Single member, manager governed; c) Basic one class percentage interests; d) Standard

form one class percentage interests; e) Long form, one class, percentage interests, buy sell provisions; f) Long form, two members, one

class, percentage interests, buy sell provisions

— Fillable PDF with LLC name and state in ﬁelds, sent via email, Cat. No. 5159PDFZ, if purchased without a kit, $18.00*. Comes with LLC kit if

you order the Cat. No. with printed forms.

— Paper forms, Cat. No. 5159, if purchased without a kit, $18.90. Comes with LLC kit if you order the Cat. No. with printed forms and specify

paper forms instead of ﬁllable pdf forms.

Minutes & Bylaws for Corporations

Model Business Corporation Act New York State BCL

5160PDFZ purchased separately, $18.00* 5150PDFZ purchased separately, $18.00*

5160 paper, $9.50 5150 paper, $9.50

Professional Corporation Bylaws, blank state, Item 5162, $10.25

Paper Minutes & Bylaws, business corporation state editions, $10.25

5170 California 5179 Georgia 5174 New Jersey

5171 Connecticut 5177 Illinois 5150 New York

5172 Delaware 5178 Michigan 5175 Pennsylvania

5173 Florida 5169 Missouri 5176 Texas

Non-Proﬁt and NY Not-for-Proﬁt Kits Minutes and Bylaws

NY not-for-proﬁt minutes & bylaws for corporations with and without members. Includes a conﬂict of interest and whistle-blower policy, committee charter, notes

and commentary.

—

PDF version s

ent by email, Cat. No. 5153PDF, $18.00* — Paper forms, Cat. No. 5153, $24.30.

— A disk with al

l the above forms for unlimited use, Cat. No. 5153D, $39.95.

Model non-proﬁt membership minutes & bylaws for all other states.

—

PDF version sent by email, Cat. No. 5161PDF, $18.00*.

—

Paper forms, Cat. No. 5161, $10.25.

The above forms are authored by the Lawyers Alliance, a nonproﬁt organization that connects nonproﬁts working in low-income New York City communities with a

network of pro bono lawyers from law ﬁrms and corporations.

*The entity name and state appear in the appropriate ﬁelds. They are sent via email. Like our paper forms, these forms can be used for one entity.

8001 ............................................................................................T689

8002 ............................................................................................T691

8004 ..............................................................................................693

8005-A .........................................................................................T278

8006 ........................................................................................... A289

8007 ........................................................................................... A291

8008 ..............................................................................................285

8009 ........................................................................................... A293

8010 ..............................................................................................296

8014 ........................................................................................... A283

8022 ........................................................................................... P679

8024 ........................................................................................... P679

8034 ...........................................................................................W295

8035 ............................................................................................T275

8041 ........................................................................................... A125

This Catalog lists all Blumberg Forms in paper and online at blumberglegalforms.com. It has two sections:

A – Z LISTING OF FORMS by speciﬁc state and Nationwide. The catalog numbers are preceded by a price code. For prices, see the Price Chart on the cover.

If the form does not have a Price Code, the prices will appear on the Numerical List. If you do not see a form listed under a speciﬁc state, look at the NATIONWIDE

LIST at p. 10.

NUMERICAL LIST of paper forms arranged sequentially by catalog number. The publication dates appear on the Numerical List.

Westlaw Form Builder with Blumberg Forms

BlumbergExcelsior, Inc., and Thomson Reuters have created a strategic licensing agreement which will add all the Blumberg’s New York forms at www.

blumberglegalforms.com to current content on Westlaw Form Builder. The list of forms covers several practice areas including litigation, real estate, landlord/

tenant and powers of attorney. With the Blumberg forms available on Westlaw Form Builder, customers will have the

ability to:

• Auto-ﬁll Blumberg forms using Westlaw document generation software;

• Purchase Blumberg forms on a subscription instead of a transaction basis; and

• Navigate more easily from Blumberg forms to Westlaw’s larger repository of forms.

For information contact Westlaw at 800 759-5418.

LEAP – Everything You Need to Run Your Law Firm

Leap cloud-based law practice management software includes the most popular Blumberg forms. For information, contact [email protected].

NEW AND REVISED FORMS. For information about:

Paper forms – go to www.blumberg.com/forms/index.html Online forms – go to www.blumberglegalforms.com/html/news.html

PUBLICATION DATES. For information about:

Paper forms – see the NUMERICAL LIST following the A – Z Index of Forms. The forms are listed sequentially by catalog number with the date of publication at

the end of the title.

Online forms – go to www.blumberglegalforms.com. Enter the catalog number in the SEARCH box. The publication date appears at the end of the title at the top

left of each form.

NEW YORK NYBTU Forms and Blumberg Equivalents. Forms without letter prefix are Web Only.

Reproduction

The forms and catalog numbers belong exclusively to BlumbergExcelsior, Inc. Permission for reproduction must be requested in writing, and is usually granted

for educational or institutional purposes. The unauthorized reproduction of our forms is forbidden. Our copyrights and proprietary rights will be strictly enforced.

Furthermore, the appropriation of our investment in composition and typography by photographic or other reproductive techniques is not allowed. Violators will be

prosecuted to the full extent of the law.

To report a violation of this policy, please contact General Counsel, BlumbergExcelsior, Inc., 100 Wall St., Suite 503, New York, NY 11241, or call 800 221-2972,

ext. 1506 or email at [email protected].

Limitation of Liability

Our forms have important legal consequences, and should be prepared and executed under the supervision of an attorney. It is the ultimate responsibility of

the attorney to determine their legal suciency for the use intended with or without change. Liability will not be accepted for any loss or damage however

caused or by whomever used.

Law Forms — New York

ACCEPTANCE (see—COOPERATIVE APARTMENT)

ACCIDENT (also see—MOTOR VEHICLE)

T 1600 Notice of intent to claim, motor vehicle MVAIC

ACKNOWLEDGMENT (also see—SUMMONS)

T 214 Indiv. corp., ptnr., witness & LLC.

AFFIDAVIT OR AFFIRMATION (also see—DOMESTIC RELATIONS—JUDGMENT—SUMMARY

PROCEEDINGS)

Affidavit of Net Worth (DRL §236) Software

Single entry of data avoids redundant typing, saves data for future update and printing,

calculates totals and updates them when you make changes,

produces an intake form for client, paste caption from word processor files.

CD program for unlimited use, Cat. No. 4600,

$119.95, Requires WIndows XP+, 128 MB ram, 14 MB drive space.

Online at www.blumberg.com/networth, for one case, $29.95

93 Affidavit, Power of attorney in full force, Web Only

T 175 Affidavit, Subscribing witness to will, at testator’s request, SCPA 1406,

Web Only

P 117 Blank, any purpose

Affidavit of Service (and affirmation where appropriate)

B 250 Affidavit, Add. mailing of summons, CPLR 3215: default judg., bl ct.

T 321 Affidavit, Mail service of papers and attorney’s affirmation, blank ct.,

Web Only

B 151 Affidavit, Summons or subpoena, personal or alt. service, ind. or corp.,

military service statement

ANNULMENT (see—DOMESTIC RELATIONS)

ANSWER (also see—NOTICE OF APPEARANCE)

T 600 Answer, blank ct.

APPEAL (see—NOTICE)

APPEARANCE (see—NOTICE OF APPEARANCE)

APPELLATE DIVISION (also see—CALENDAR PRACTICE—RETAINER)

T 471 Notice of appeal

APPLICATION (also see—LANDLORD & TENANT)

T 601 Application for index number, CPLR 8018(a)2

ASSIGNMENT (also see—COOPERATIVE APARTMENT—LANDLORD & TENANT—MORTGAGE: REAL

ESTATE—Nationwide Forms)

ASSUMED NAME CERTIFICATE (see—CERTIFICATE)

ASSUMPTION (see—COOPERATIVE APARTMENT—MORTGAGE)

ATTORNEY (also see—POWER OF ATTORNEY)

X 317 Consent. change (substitution) of attorney, blank ct.

AUTHORIZATION (see—CALENDAR PRACTICE)

AUTOMOBILE (see—ACCIDENT)

BILL OF COSTS (see—JUDGMENT)

BILL OF PARTICULARS (see—NOTICE OF APPEARANCE)

BILL OF SALE

W 81 Of business, UCC bulk transfer

M 187 Of business, affid. of title, restriction cl.

BUSINESS (see— BILL OF SALE — CERTIFICATE—CORPORATION—Nationwide Forms)

BY-LAWS (see—CORPORATION)

CALENDAR PRACTICE

Business Records

B 32 Certification of business records, CPLR §3122-a(a), Web Only

B 31 Notice of intent to offer business records authenticated by

certification, CPLR §3122-a(c), Web Only

B 33 Notice that items produced pursuant to subpoena are available for

inspection and copying, CPLR §3120(3), Web Only

B 34 Subpoena duces tecum, medical records, witness’ stipulation, CPLR

§2305(b), Web Only

Demand and Request

B 344 Demand for jury, Web Only

T 305 Request for preliminary conference, 202.12(a), Web Only

Health and Hospital Records (also see—ACCIDENT)

T 555 Authorization for release of health information pursuant to HIPPA,

OCA 960, Web Only

C 542 Request for hospital record & medical report, for use by attorney to

examine client’s record, Web Only

T 543 Request for patient information, PHL§18, Web Only

T 3129 Authorization to release medical and hospital records

Notice of Motion

384 Universal notice of motion, Web Only

Note of Issue

B 537 Note of issue, certificate of readiness, all departments

Notice of Trial and Certificate of Readiness

B 168 Notice of trend or request with statements, Civil Ct., one side typing,

22 NYCRR 208.17, Web Only

B 1468 District Ct., one side typing, 22 NYCRR 212.17, Web Only

Preliminary Conference

T 305 Request for preliminary conference, 22 NYCRR 202.12(a), Web Only

CANCELLATION (see—CERTIFICATE—LIS PENDENS)

CERTIFICATE (also see—CALENDAR PRACTICE)

Business Certificate (Trade Name, DBA’s, Assumed Name)

T 639 Amendment of assumed name, corporation, Web Only

T 224 Amended business certificate. ind. or partners

T 341 Cancellation of business certificate, individual

T 176 Cancellation of partnership certificate

T 339 Certificate of use of assumed name by corporation, Web Only

X 74 Conducting business as partners (corp. may be a partner)

X 201 Conducting business under trade name, individual

T 638 Discontinuance of assumed name, certificate of

CITY COURT- “BLANK” CITY (see—JUDGMENT—SUMMONS & COMPLAINT—SUMMARY

PROCEEDINGS)

CIVIL COURT (also see—ENFORCEMENT OF JUDGMENT—SUMMARY PROCEEDINGS—SUMMONS)

B 300 Notice of appear., answer, demand for bill of particulars

B 168 Notice of trial or inquest, certificate of readiness 22 NYCRR 208.17,

Web Only

B 314 Stipulation discontinuing action

T 140 Affidavit, show cause order, vacate eviction judgment

B 319 Judgment on default, Web Only

T 306 Judgment on default, verified compl., non-military service, Web Only

B 323 Judgment on inquest or after trial

CLAIM (see—ACCIDENT—NOTICE—PROOF)

CLOSING STATEMENT (see—RETAINER)

COMPLAINT (see—DEMAND—FORECLOSURE—SUMMONS & COMPLAINT)

CONDOMINIUM

M 124 Contract of sale, residential condominium unit, Web Only

M 146 Contract of sale, Ass’n of the Bar of the City of N.Y., Web Only

New York — Law Forms

Gray-highlighted forms are online at blumberglegalforms.com

A 101 Lease of a condominium unit

M 102 Lease of a condominium unit, comprehensive, 11 pps., 12/pkg.

T 366 Notice of lien for common charges, Condominium Act, RPL

§339-z, 339-aa

CONFERENCE (see—CALENDAR PRACTICE)

CONFESSION OF JUDGMENT (see—JUDGMENT)

CONSENT (see—ATTORNEY—STIPULATION)

CONTRACT (also see—CONDOMINIUM—COOPERATIVE APARTMENT—Nationwide Forms )

T 136 Home improvement contract cover sheet, GBL §§770-796

125 Real estate, residential, jt. bar association form, 6 pps.

B 122 Purchase offer real estate (binder), plain English

M 124 Real estate, sale of residential condominium

M 146 Real estate, condominium, Assn. of the Bar of the City of N.Y.

154 Real estate, sale of office, commercial and multi-family residential

purposes, Assn. of the Bar of the City of N.Y., Web Only

8126 Real estate, capital region, Web Only

M 1128 Real estate, sale of land, Web Only

P 1122 Real estate, sale of land, shortest form

337 Real estate, sale of, short form, double sheet, Web Only

A 311 Real estate, subordination of mortgage, NYBTU 8030, Web Only

W 82 Sale of business, ind. or corp.

CO-OPERATIVE APARTMENTS

T 395 Acceptance of, assign., assumption of proprietary lease, Web Only

T 396 Assignment of proprietary lease, Web Only

397 Consent and assignment of proprietary lease, Web Only

123 Contract of sale, financing condition, NYSBA form

T 394 Recognition agreement, joint bar committee form, Web Only

86 Sublease of a cooperative apartment, 13 pp, Web Only

CORPORATION

Business Corporation Law (BCL)

639 Amendment of assumed name, certificate, corporation, Web Only

T 339 Assumed name, certificate of use by corporation, Web Only

T 638 Discontinuance of assumed name, certificate of

T 333 Dissolution certificate, BCL Sec. 1003, Web Only

A 234 Incorporation certificate, business, BCL Sec. 402, Web Only

A 191 Incorporation certificate, not-for-profit corp, Web Only

Printed Minutes & By-Laws, Paper and PDFs

5150 New York Business Corporation (BCL)

5150PDF

New York Business Corporation (BCL) fillable PDF with

corporate name and state in fields, sent via email, $18.00

5152 New York Professional Corporation (Art. 15)

5153 NY minutes and bylaws for a not-for-profit corporation with suggested

default language, Skadden commentary about the changes in the law, Lawyers

Alliance commentary about the forms. Notes with suggested language for fields

(6-17), $15.75 with Not-for-Profit corporate kit, $22.50 without kit. Includes

these forms:

5153MEM – Membership Corporation: bylaws, organization

minutes, waiver of notice, title page

5153WOM – Corporations without members: bylaws,

organization minutes, waiver of notice, title page

5153CIP – Conflict of Interest Policy, notes

5153WB – Whistleblower Policy, notes

5153AC – Audit Committee Charter, notes

5153D Disk with all the paper forms listed above, editable default language,

footnotes and commentaries, unlimited use, $39.95

COSTS (see—JUDGMENT)

COUNSEL FEES (see—RETAINER)

COUNTY COURT USE “BLANK COURT” FORMS

COURT OF APPEALS (see—NOTICE)

DEEDS All forms Individual or Corporation and include lien clause

298 Administrator’s, Web Only

A 291 Bargain & sale, covenant, NYBTU 8007, long form

T 691 Bargain & sale, covenant, NYBTU 8002, short form

A 289 Bargain & sale, no covenant, NYBTU 8006, long form

T 689 Bargain & sale, no covenant, NYBTU 8001, short form

A 296 Executor’s NYBTU 8010, long form, Web Only

T 278 Executor’s NYBTU 8005-A, short form

A 293 Quitclaim, NYBTU 8009, long form

T 693 Quitclaim, NYBTU 8004, short form, Web Only

M 294 Quitclaim, long form D, Web Only

P 694 Quitclaim, short form D, Web Only

P 1693 Quitclaim, 1 side recording D

A 285 Warranty, full covenants, NYBTU 8008, long form, Web Only

P 688 Warranty, full covenants, short form A, Web Only

1688 Warranty, full covenants, 1 side recording A, Web Only

290 Warranty, basic covenants, long form A, Web Only

P 678 Warranty, basic covenants, short form A

P 1678 Warranty, basic covenants, 1 side recording A

DEFAULT (see—JUDGMENT—SUMMARY PROCEEDINGS)

DEMAND (also see—JURY—NOTE—NOTICE OF APPEARANCE)

T 132 Demand for service of complaint, CPLR 3012 (b), Web Only

DEPOSITION (see DISCLOSURE—NOTICE)

DISCHARGE (see—MORTGAGE: REAL ESTATE—RELEASE)

DISCLOSURE (also see—REAL ESTATE)

436 Notice to take deposition on oral exam, negligence, Blank Ct.,

Web Only

438 Notice to take deposition on oral exam, general use, Blank Ct.,

Web Only

DISCONTINUANCE (see—CERTIFICATE—STIPULATION)

DISPOSSESS (see—SUMMARY PROCEEDINGS)

DISSOLUTION (see—CORPORATION—PARTNERSHIP)

DISTRICT COURTS (also see—ENFORCEMENT OF JUDGMENT—SUMMONS & COMPLAINT—

SUMMARY PROCEEDINGS)

DOMESTIC RELATIONS

Affidavit of Net Worth (DRL §236) Software

Single entry of data avoids redundant typing, saves data for future update and printing,

calculates totals and updates them when you make changes,

produces an intake form for client, paste caption from word processor files.

• softwre for unlimited use

• single case

Online at www.blumberg.com/networth

T 179 Affidavit of residence of child, DRL 75j, Web Only

T 141 Post card, matrimonial action

A 455 Retainer agreement, Matrimonial Rules, based on clauses approved by

the NY Chapter of the American Academy of Matrimonial Lawyers

and the Family Law Sections NYSBA Bar Association

T 454 Statement of client’s rights and responsibilities

A 496 Statement for proposed distribution, 22 NYCRR 202.16

T 163 Summons, annulment

T 158 Summons, divorce action, blank relief, UD-1, Web Only

Law Forms — New York

ENFORCEMENT OF JUDGMENT (Article 52 CPLR)

Income Executions

T 439 Blank Court

T 139 Support enforcement, blank court CPLR 5241, Web Only

Property Executions

T 120 Blank ct., notice to garnishee

460 Blank ct., without notice to garnishee, Web Only

B 320 Civil Ct., notice to garnishee, Web Only

Supplementary Proceedings (a) Information Subpoenas;

use with Questionnaires under (b) below

412 Civil Ct. with restraining notice and notice to garnishee or witness,

Web Only

X 417 Blank Ct., to judgment debtor or to witness

(b) Questionnaire, also see above (a) Information Subpoena

351 Questions for individual debtor, blank ct., Web Only

W 251 Questions for corporate debtor, blank ct.

T 427 Questions financial institution, use with information subpoena,

No. T 410, X 407 or X 417, Web Only

use separate notice if subpoena does not contain restraining notice

X 411 Judgment debtor, blank ct.

412 Information subpoena, restraining notice to garnishee, CPLR 5222(e),

certification, Civil Ct., Web Only

429 Subpoena duces tecum, judgment debtor, restraining notice, blank ct.,

Web Only

418 Witness, duces tecum, restraining notice: blank ct., Web Only

(d) Restraining Notices (may be used with subpoenas)

421 Exemption notice & exemption claim form, CPLR 5222-a(b),

serve two with restraining notices, Web Only

415 To judgment debtor, CPLR 5222, blank ct., Web Only

T 416 To garnishee, CPLR 5222, blank ct.

(e) Notice to judgment debtor

T 426 Notice to judgment debtor, a natural person, CPLR 5222 (d)

& (e) blank ct.

EVICTION (see—SUMMARY PROCEEDINGS)

EXAMINATION (see—DISCLOSURE— ENFORCEMENT OF JUDGMENT—NOTICE)

EXCHANGE OF MEDICAL INFORMATION (see—CALENDAR PRACTICE)

EXECUTION (see—ENFORCEMENT OF JUDGMENT)

EXTENSION (see—LANDLORD & TENANT—STIPULATION)

GARNISHEE (see—ENFORCEMENT OF JUDGMENT)

HEALTH CARE (also see—POWERS OF ATTORNEY, AGENTS, HEALTH CARE)

P 70 Health care proxy, PHL 2980

M 95 Same, with living will directives

HOLDOVER (see—SUMMARY PROCEEDINGS)

HOSPITAL RECORDS (see—CALENDAR PRACTICE)

INCOME (see—ENFORCEMENT OF JUDGMENT)

INDEX NUMBER (see—APPLICATION)

INFORMATION (see—ENFORCEMENT OF JUDGMENT)

JUDGMENT (also see—ENFORCEMENT OF JUDGMENT)

Default Judgment

B 250 Affidavit of additional mailing of summons. CPLR 3215(f)(3),

blank ct.

X 157 Blank Court, judgment on failure to appear or plead, Web Only

B 319 Civil Court, judgment on default, Web Only

T 306 Civil Court, judgment on default, verified complaint, military

service affid., Web Only

T 1419 District Court, blank county, Web Only

213 Stipulation and consent, vacate default judgment, CPLR §5015,

Web Only

After Trial or Inquest—Judgment

X 156 Blank Court, bill of costs (with CPLR sections), Web Only

B 323 Civil Court, judgment on inquest or after trial

Motion For Summary Judgment

A 170 On instrument or judgment, notice of motion, affidavit, order,

summons in lieu of complaint, blank ct.

Miscellaneous

X 245 Confession of judgment, ind., corp.: blank court, Web Only

B 242 Satisfaction of judgment, whole or partial, blank ct., Web Only

T 1165 Uniform transcript of judgment: blank court

JURY DEMAND

B 344 Blank Court, Web Only

JUSTICE COURT (see—SUMMONS—SUMMARY PROCEEDINGS & other special headings)

LANDLORD & TENANT (also see—SUMMARY PROCEEDINGS—Nationwide Forms)

DHCR Forms for Stabilized and Controlled Apartments

326 Rent stabilization rider, use with M56, T327 and A53, pkg. of 25 RSA

Rider online as part of a collection of lease riders Cat. No. 61

326BX Same, box of 250, quantity pricing

330 Renewal lease (RTP-8), pkg. of 25, 3pt. carbonless sets

330BX Same, box of 250, quantity pricing

330CTY RTP-8 for Westchester, Nassau & Rockland, Web Only

Forms prepared by Adam Leitman Bailey, Leonard H. Ritz and Dov Treiman

M 56 Lease of a regulated apartment, modern and comprehensive, 13pps.

M 57 Lease of an unregulated apartment, modern and comprehensive, 13pps.

86 Lease of a cooperative apartment, Web Only

65 Apartment house laundry service license, Web Only

66 Apartment house laundry service lease, Web Only

58 Apartment house rules, comprehensive, Web Only

3210 Office license agreement, Web Only

Residential leases revised with simplified language

Apartment Leases Unregulated

A 186 Apartment lease, 2-5 units, furn/unfurn, plain English, 4 pp.

A 261 Replaced by revised form A186.

T 202 Lease from month to month

303 Apartment lease, furn/unfurn, plain English, 4 pp., Web Only

T 48 Apartment lease, balanced moderate coverage, plain English, 2 pp.

A 55 Apartment lease, comprehensive, guaranty, acknowledgments, plain

English, 4pp., 7-19

M 57 Lease for an unregulated apartment, 13 pp.,

Apartment Leases Regulated

A 327 Apartment lease, stabilized/controlled, plain English, 2 pp.

A 53 Replaced by revised form A327

M 56 Lease for a rent stabilized apartment, 13 pp.

House Leases

3120NY House lease with option to buy, plain English, furnished or

unfurnished, Web Only

A 54 House lease, furn/unfurn, moderate coverage, plain English, 4 pp.

A 495 Replaced by revised form A54.

Condominium Leases

101 Condominium unit lease, plain English, 8 pp.

102 Condominium unit lease, comprehensive, 11 pp., Web Only

Cooperative Lease

86 Sublease of a cooperative apartment, 13 pp., Web Only

New York — Law Forms

Gray-highlighted forms are online at blumberglegalforms.com

Seasonal Lease

315 Weekly vacation residence lease, plain English, furnished, 2 pp.,

Web Only

313 Seasonal/vacation lease, house/apartment, furnished, plain English,

2pps.

Sublease

P 193 Sublease, any purpose (incl. coop. apt.)

Commercial leases

103 Comprehensive office lease, limited “good guy” guaranty,

prepared by Arnold Mandell, Esq., 26 pp., Web Only

197 Extension of commercial lease, Web Only

3210 Office license agreement, Web Only

256 Office, loft, marginal headings, coverage, double sheet, Web Only

A 35 Store, loft, office, margin captions, full cls., dbl. sheet

A 185 Store, Gilsey form security clause, double sheet

226 Store, security clause, substantial coverage, dbl. sheet, Web Only

Miscellaneous forms related to Leases

67 Application for residential apt. §20-808, NYC Admin. Code,

Web Only

223 Application to sublease apartment, RPL §226-b, Web Only

T 586 Assignment of lease with assumption

W 281 Assignment of lease

483 Assignment of rent, Web Only

286 Collateral assignment of leases & rents, Web Only

T 3112 Inventory of furniture and furnishings (lease rider or checklist)

36 Limited “good guy” guaranty, prepared by Arnold Mandell, Esq.,

Web Only

B 119 Notice to tenant, 3 days, non-payment of rent, English/Spanish:

public assistance statement

B 307 Notice to tenant, 30 days to terminate monthly tenancy or

month-to-month

329 Sprinkler statement residential lease rider, Web Only

T 308 Ten day notice to quit where no landlord and tenant relationship

exists

LIEN (also see—LIS PENDENS)

A 167 Mechanic’s notice of: ind., part., corp. (N.Y.C. form)

A 365 Mechanic’s notice of: ind., part., corp. (outside N.Y.C.)

T 231 Mechanic’s lien, satisfaction of, ind., corp.

T 386 Mechanic’s lien on public improvements

T 366 Notice of lien for common charges, Condominium Act, RPL §339-z,

339-aa

LIMITED LIABILITY COMPANY

LLC OPERATING AGREEMENT AND GOVERNANCE DOCUMENTS

Prepared by Lauris G. L. Rall and Richard Williams

A thorough and tax-sensitive set of documents to govern the LLC during its lifetime.

Suitable for member and manager governed LLC’s.

A commentary by the author is included. The documents are:

NEW Fillable PDF with LLC name and state in appropriate fields, sent via email,

Cat. No. 5154PDFZ, if purchased without a kit, $18.00. Comes with LLC kit if you

order the Cat. No. with printed forms.

Printed documents, 50 pps., 25% cotton fiber 8

⁄2" x 11" paper, 3-hole punched,

Cat. No. 5154, $17.50 with complete LLC kit, extra.

1A–Member Managed Single Member

Operating Agreement

1B–Manager Managed Single Member

Operating Agreement

2A–Manager Managed Multiple Member

Operating Agreement, Consent of

Members, Consent of Managers and

Company Regulations

2B–Member Managed, Multiple Member

Operating Agreement

LIS PENDENS

368 Stip. canceling lis pendens, attorney’s affidavit, CPLR 6514 (d),

Affirmation of atty. cancel lis pendens CPLR 6514 (e), Web Only

LIVING WILL (see—WILL)

LOAN (see—MORTGAGE)

MALPRACTICE

T 461 Notice of medical malpractice action, 22 NYCRR 202.56(b)

MATRIMONIAL ACTION (see—DOMESTIC RELATIONS)

MECHANIC (see—LIEN)

MEDICAL (see—CALENDAR PRACTICE—MALPRACTICE—RETAINER)

MORTGAGE, REAL ESTATE (also see—Nationwide Forms)

A 283 Mortgage long form, NYBTU 8014

Real Estate Bond/Note

T 27 Mortgage note, NYBTU 8011

Simplified Language Mortgages and Notes

M 687 Collateral security mortgage, Web Only

P 666 Combined note and mortgage, short form

P 670 Mortgage, short form, Web Only

M 671 Mortgage, long form, Web Only

P 675 Mortgage note, Web Only

Miscellaneous forms Related to Real Estate Mortgages

P 679 Assign. of mortgage, covenant, NYBTU 8022, 8024, Web Only

P 586 Assumption of mortgage clause in assignment of lease

W 295 Release of part of the mortgaged premises: NYBTU 8034

T 1624 Satisfaction of mortgage, 1 side recording

T 275 Satisfaction of mortgage, NYBTU 8035

MOTION (also see—JUDGMENT—NOTICE)

37 Motion decision alert letter, NYCRR §202.8(h), Web Only

MOTOR VEHICLE

T 1600 Notice of intent to make claim, MVAIC

NAME CHANGE

39 Petition & order, change name, counties outside NYC, Web Only

NEGLIGENCE (see—ACCIDENT)

NOTE (also see—MORTGAGE—Nationwide Forms)

B 1000N Serial note, accel., 4 notes on each sheet, perforated, endorser waives

presentment, demand, notice of protest & of dishonor on back:

individual, 100 on pad

NOTE OF ISSUE (see—CALENDAR PRACTICE)

NOTICE (also see—ACCIDENT—APPELLATE DIVISION—CALENDAR PRACTICE—CIVIL COURT—

CONDOMINIUM—DEMAND—DISCLOSURE—LANDLORD & TENANT—LIEN—MOTOR VEHICLE—

NOTICE OF APPEARANCE)

T 471 Appeal, notice of

T 1183 Claim, notice of intent to sue any public auth. GML 50

T 29 Claim & notice of intent to sue blank Transit Authority

T 1600 Claim, notice of intent, motor veh., MVAIC

B 438 Examination before trial, blank action: blank ct., Web Only

B 436 Examination before trial, negligence action: blank ct., Web Only

T 461 Medical malpractice action, 22 NYCRR 202.56(b), Web Only

435 New hire, ack. of wage rate, LL §195(1), Web Only

64 Notice of intention to introduce into evidence a bill for automobile

repairs, verification, CPLR 4533a., Web Only

257 Notice of intention to introduce Xrays at trial, affirmation of physician,

CPLR 4532a., Web Only

258 Notice of intention to introduce into evidence a bill for service or

repairs, verification or affirmation, CPLR 4533a., Web Only

384 Uniform notice of motion, Web Only

Law Forms — New York

NOTICE OF APPEARANCE

C 131 Blank court, appearance & demand, Web Only

B 300 Civil Ct., appear, answer, demand bill of particulars, Web Only

NOTICE OF TRIAL OR INQUEST (see—CALENDAR PRACTICE)

ORDER (see—SUMMARY PROCEEDINGS)

PETITION (see—SUMMARY PROCEEDINGS)

PHYSICIANS (see—CALENDAR PRACTICE—NOTICE)

POWER OF ATTORNEY (also see—CORPORATION—Nationwide Forms)

M 40 Non-statutory, commercial (business, finance & real estate), prepared

by Donovan & Giannuzzi, LLP, 4 pp.

93 Affidavit that POA is in full force and effect, Web Only

M 43 Statutory, non durable, affidavit of attorney, 6 pp.

M 44 Statutory, durable, without affidavit of attorney, 4 pp.

M 49 Statutory, effective at a future time (springing), durable, affidavit of

attorney, 6 pp.

M 51 Statutory, durable, affidavit of attorney, 6 pp.

P 45 Statutory form, major gifts rider, 8

⁄2"x 11"

462 Revocation of power of attorney

P 70 Health care proxy 2 pps.

M 95 Health care proxy with living will directives, 2pps

P 42 Appointment of agent to control disposition of remains, GBL §453,

2 pps

PRELIMINARY CONFERENCE (see—CALENDAR PRACTICE)

PROMISSORY NOTE (see—NOTE)

PROPERTY EXECUTION (see—ENFORCEMENT OF JUDGMENTS)

PROOF (see—Nationwide Forms)

PROPRIETARY LEASE (see—COOPERATIVE APARTMENT)

PUBLIC IMPROVEMENT (see—LIEN)

PURCHASE AND SALES BOOK (see—SECOND HAND ARTICLES)

QUESTION & ANSWERS (see—ENFORCEMENT OF JUDGMENTS)

QUITCLAIM (see—DEED)

REAL ESTATE (also see—CONTRACT—DEED—LANDLORD & TENANT—MORTGAGE, REAL ESTATE—

Nationwide Forms)

130 Property condition disclosure statement, space for answers, 4 pps. letter

size, CRPL §462

RELEASE (also see—LIEN—MORTGAGE, REAL ESTATE)

T 472 To executor or administrator, with receipt, ind., corp.

B 110 General, individual

B 111 General, corporation, Web Only

T 112 General release, joint tortfeasor’s clause, ind., corp., Web Only

T 215 Lease, surrender of, ind., corp.

RENEWAL (see—LANDLORD & TENANT)

REPOSSES (see—SUMMARY PROCEEDINGS)

REQUEST (see—CALENDAR PRACTICE)

RESIDENCE AFFIDAVIT (see—AFFIDAVIT—Nationwide Forms)

RESTRAINING (see—ENFORCEMENT OF JUDGMENTS)

RETAINER, ENGAGEMENT

P 490 Attorney’s written letter of engagement, 22 NYCRR 1215, Web Only

B 547 Receipt post card for OCA statements of retainer and closing

548 Retainer, sliding scale, App. Div., 1st & 2nd Dept., Web Only

T 540 Retainer, straight 33

⁄3%, App. Div., 1st & 2nd Dept. Statement as to

Retainer

B 541 Statement as to retainers, App. Div., 1st & 2nd Dept., blank fee. also

condemnation

549 Statement as to retainers, App. Div., 1st & 2nd Dept., sliding scale

B 538 Closing state., contingent fee, App. Div. 1st & 2nd Dept.

SALE (see—CONTRACT—Nationwide Forms)

SATISFACTION (see—JUDGMENT—LIEN—MORTGAGE, REAL ESTATE—RELEASE)

SECOND HAND ARTICLES

629 Purchase and sale record, bound book of 50 sets, 2-pt.

630 Dealers record of purchases: precious metals

SEPARATION (see—DOMESTIC RELATIONS)

SERIAL NOTE (see—NOTE)

SEVERANCE AGREEMENT

98 Severance agreement & general release, Web Only

STATEMENT (see—DOMESTIC RELATIONS—RETAINER—SUMMONS— Nationwide Forms)

STIPULATION

260 Adjourning trial, Blank Court, Web Only

213 And consent to vacate judgment, Blank Court, Web Only

X 317 Change (substitution) of attorney, consent, blank ct.

200 Extending time to answer, Blank Court, Web Only

259 Extending time to serve complaint, Blank Court, Web Only

STOCK POWERS (see—Nationwide Forms)

SUBPOENA (also see—ENFORCEMENT OF JUDGMENTS)

C 73 Blank Ct., witness stipulation to remain subject to call, Web Only

B 69 Blank Ct., duces tecum, witness’ stip. remain subj. to call

B 72 Blank Court, duces tecum, , witness’ stip. remain subj. to call,

CPLR 2305(b)

34 Same, for medical records, patient authorization, CPLR §3122(a),

Web Only

SUBSCRIBING WITNESS (see—WILL)

SUMMARY JUDGMENT (see—JUDGMENT)

SUMMARY PROCEEDINGS (RPAPL)

(a) Civil Court, Non-payment—also see (e) below

T 140 Affidavit & order to vacate judgment of eviction

T 206b Original petition, non-payment business

T 207b Original notice of petition, non-payment business

T 206d Original petition non-payment dwelling

T 207d Original notice of petition, non-payment dwelling

(b) Civil Court, Holdover, also see (e) below

T 140 Affidavit & order to vacate judgment of eviction

X 210 Original petition, holdover-dwelling or business

X 211 Original notice of petition, holdover-dwell. or business

X 444 Original petition non-payment dwelling or business

X 445 Original notice of petition, non-payment dwell. or bus.

T 447 Warrant, non-payment, dwelling or business, Web Only

T 519 Judgment, evict. & rent, default, non-pay. dwell. or bus.

T 523 Judgment, eviction & rent, trial or inquest, non-payment, dwelling or

business, Web Only

(d) Blank Court, Holdover, also see (e) below

T 448 Original petition holdover, dwelling or business

T 449 Original notice of petition, holdover, dwelling or business

453 Warrant, holdover, dwelling or business, Web Only

T 530 Judgment of eviction, default, after trial or inquest, holdover, dwelling

or business

Gray-highlighted forms are online at blumberglegalforms.com

NY and NJ — Law Forms

(e) Eviction Proceedings Based on Any Grounds, Blank Court

T 510 Original petition, any grounds

T 511 Original notice of petition, any grounds

(f) “Blank” County, District Court, also see (e) above

T 1406 Original petition, non-payment, dwelling or business

T 1407 Original notice of petition, non-payment, dwell., or business

T 1412 Judgment, evict. & rent, default, non-pay., dwell. or bus.

T 1410 Original petition, holdover, dwelling or business, Web Only

T 1411 Original notice of petition, holdover, dwell. or business, Web Only

T 1409 Warrant, holdover, dwelling or business, Web Only

1414 Judgment of eviction, default, after trial or inquest, holdover, dwelling

or business, Web Only

(g) Notices

212 Eviction notice postcard, holdover, Civil Ct.

216 Eviction notice postcard, non payment Civil Ct.

204 Landlord’s notice to enter premises, Web Only

B 119 Notice to tenant, 14 days

T 304 Notice to tenant by certified mail, 5 days

T 307 30-days, terminating monthly or month-to-month tenancy

T 309 Omnibus notice to terminate tenancy: 30, 60 or 90 days

SUMMONS: SUMMONS AND COMPLAINT (also see—AFFIDAVIT—NOTICE)

All summons are 12 pt. type.

266S Statement of service and acknowledgment of receipt, 3 pt.

carbonless, black print, white sets, 25 sets to envelope, Web Only

Blank Court

B 106 Blank Ct. summons, with notice

B 104 Blank Ct. summons, without notice, Web Only

Civil Court

264 Served with a formal complaint, Web Only

B 268 Endorsed or annexed formal compl., 22 NYCRR 208.6(b), Web Only

District Court

1466 Endorsed complaint, Web Only

1464 Serve with formal complaint, Web Only

Justice Court

T 1161 Endorsed compl., 22 NYCRR 214.3(b)

Supreme Court

T 163 Supreme Ct., summons with notice, annulment

T 158 Supreme Ct., summons with notice, divorce action, Web Only

B 198 Supreme Ct., summons with notice

B 199 Supreme Ct., summons without notice

SUPPORT (see—ENFORCEMENT OF JUDGMENT—Nationwide Forms)

SURROGATE (see—AFFIDAVIT—RELEASE)

TRADE NAME (see—CERTIFICATE)

TRANSCRIPT

T 1165 Uniform transcript of judgment, any court

TRIAL (see—CALENDAR PRACTICE)

VACATE JUDGMENT (see—SUMMARY PROCEEDING)

VEHICLE (see—ACCIDENT—MOTOR VEHICLE—Nationwide Forms)

VERIFICATION (see—NOTICE)

WAIVER (see—LIEN)

WARRANT (see—SUMMARY PROCEEDINGS)

WARRANTY DEED (see—DEED)

WILL

M 95 Health care proxy with living will directives

3111 Affidavit of witnesses, memorandum of execution of will

and instructions, 4 pp., Web Only

P 3202 Living Will

177 Will, married person, affidavit of subscribing witnesses, execution

instructions, 8pp., Web Only

178 Will, unmarried person, affidavit of subscribing witnesses, execution

instructions, 8pp., Web Only

P 181 Will, 2 pg., affidavit of subscribing witnesses, 8

⁄2" x 14"

M 1683 Same as P1682, 4 pg., large blank space, 8

⁄2" x 11"

New Jersey

All consumer contracts for New Jersey comply with the New Jersey Plain

Language Law effective April 15, 1982. The Publisher has received approval

from the Attorney General.

APPROVAL OF A CONSUMER CONTRACT (OR ANY WRITING REQUIRED TO COMPLETE A

CONSUMER TRANSACTION) PURSUANT TO THE PLAIN LANGUAGE LAW IS NOT AN APPROVAL

BY THE ATTORNEY GENERAL OF THE CONTRACT’S SUBSTANCE OR OF ITS LEGALITY OR LEGAL

EFFECT.

BILL OF SALE (see—Nationwide Forms)

CERTIFICATE (see—Nationwide Forms)

928 Business name certificate, Web Only

CORPORATION (see—Nationwide Forms)

LIEN

973 Mechanic’s lien claim, Web Only

POWER OF ATTORNEY (also see—Nationwide Forms)

931 General durable power of attorney, Web Only

930 Statutory form, banking cl., disability options, NJS 46:2B-8, Web Only

REAL ESTATE PRACTICE

922 Contract of sale, comprehensive form, Web Only

M 916 Contract of sale, standard, Web Only

M 913 Contract of sale, realty broker’s attorney review section, Web Only

W 123 Cooperative apt., sales contract, financing condition

M 912 Deed, quitclaim ind. or corp., Web Only

M 918 Deed, bargain and sale without cov. ind. or corp., Web Only

919 Deed, bargain and rate, covenant, ind. or corp., Web Only

A 901 Deed, warranty, full covenants, ind., corp., Web Only

M 915 Lease, apartment, comprehensive form

P 890 Lease, apartment, short form

A 880 Lease, business, loft or office, marginal headings, double page

P 889 Lease, house furnished or unfurnished

879 Lease, business, Web Only

RELEASE

P 908 General release, plain English, Web Only

SEVERANCE AGREEMENT

801 Severance agreement and general release, Web Only

WILL

977 Will, married person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

978 Will, unmarried person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

M 911 Will, affidavit of executor and witness, self proving affidavit, Web Only

P 3202 Living will

3111 Affidavit of witnesses, memorandum of execution of will and

instructions, 4 pp., Web Only

T 175 Affidavit of sub.scribing witness, SCPA 1406, Web Only

Law Forms — CA, CT, FL, GA, IL, MA, NC, OH, PA and TX

California—also see Nationwide Forms

2101 Statutory general durable power of attorney, Web Only

Connecticut—also see Nationwide Forms

CERTIFICATE

T 1221 Registration of trade name, Web Only

CORPORATION (also see—Nationwide Forms)

Printed Minutes & By-Laws

5171 Connecticut business corporation, minutes and by-laws

DEED

W 1294 Quit claim deed, double sheet, Web Only

LANDLORD & TENANT (also see—Nationwide Forms)

Leases

M 1251 Apartment, furnished or unfurnished

A 880 Business premises, marginal headings, 28 clauses

W 1249 Business premises, double page, Web Only

M 1252 House, furnished or unfurnished

POWER OF ATTORNEY (also see—Nationwide Forms)

1219 Advanced directives (optional): appointment of health care

representative, living will or health care directives, document of

antomical gift and designation of conservator of the person, Web Only

M 1220 General power of attorney, disability and inducement clause, Statutory

Short Form

SEVERANCE AGREEMENT

1201 Severance agreement and general release, Web Only

Florida—also see Nationwide Forms

1921 Equal dignity mortgage, Web Only

1923 Contract, sale of unimproved real estate, with due diligence period,

Web Only

1930 General durable power of attorney; acknowledgment and affidavit of

agent., Web Only

1932 Designation of healthcare surrogate, acknowledgment, affidavit of

agent, Web Only

1940 Commercial lease, retail store, Web Only

1945 Notice to residential tenant for rent due, 3 days, Web Only

1945SP Notice to residential tenant for rent due, 3 days, English & Spanish,

Web Only

1951 Residential house lease, unfurnished, Web Only

1952 Residential lease, furnished apartment, schedule of furnishing,

Web Only

1953 Residential apartment lease, unfurnished, Web Only

1954 Lease of condominium unit, Web Only

1956 General release by an individual, Web Only

1957 General release by a corporation or LLC, Web Only

1960 FL severence agreement & general release, Web Only

1977 Will, married person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

1978 Will, unmarried person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

3106 Land trust agreement, Web Only

Georgia—also see Nationwide Forms

1875 Apartment lease, 2-3 unit building, furnished (with schedule), or

unfurnished, 8pps., Web Only

1876 House lease, furnished (with schedule), or unfurnished, 8 pps.,

Web Only

1877 House lease, unfurnished, 4pps., Web Only

1886 Statutory financial power of attorney, explanations, GA Code §106142

(2010), 7 pp., Web Only

Illinois—also see Nationwide Forms

3170 Statutory short form power of attorney, Web Only

3171 Severance agreement and general release, Web Only

Massachusetts—also see Nationwide Forms

3160 General durable power of attorney, healthcare proxy & living

wishes statement, 6pp.

North Carolina—also see Nationwide Forms

54-305 Residential property and owner's association disclosure statement,

4 pp., Web Only

54-401 NC residential lease: apartment, condominium, house and mobile

home, Web Only

55-301 Deed of trust, 3 pp., Web Only

55-601 General warranty deed, 2 pp., Web Only

55-701 Quitclaim deed, 2 pp., Web Only

55-720 Release deed, 2 pp., Web Only

55-832 Statutory short form power of attorney, 2 pp., Web Only

55-835 Health care power of attorney, 4 pp., Web Only

55-890 North Carolina Living will, Web Only

Ohio—also see Nationwide Forms

3230 Ohio statutory power of attorney, durable, 4 pp., Web Only

Pennsylvania—also see Nationwide Forms

A 1890 Apartment lease, comprehensive form for a multiple dwelling, furnished

or unfurnished, Web Only

A 1891 Apartment lease, owner occupied multiple dwelling, furnished or

unfurnished, Web Only

A 1892 Seasonal, short term lease. Used for vacation homes and seasonal terms,

Web Only

A 1893 House lease

A 1894 Lease of a condominium unit, Web Only

1896 Commercial retail lease (e.g., store, strip center, shopping center),

comprehensive short form. Revised and improved by Frank N.

Tobolsky, Esq., Web Only

1898 Severance agreement and general release, Web Only

1899 General durable power of attorney, Web Only

T 3112 Inventory of furniture and furnishings (lease rider or checklist)

Texas—also see Nationwide Forms

3132 Severance agreement & general release, Web Only

3145 Notice to vacate for breach of covenant, Web Only

3146 Notice to vacate for nonpayment, Web Only

3150 Statutory durable power of attorney, Web Only

3151 Residential lease, unfurnished house, Web Only

3152 Residential lease, furnished apartment, schedule of furnishings,

Web Only

Gray-highlighted forms are online at blumberglegalforms.com

TX and Nationwide — Law Forms

3153 Residential lease, unfurnished apartment, Web Only

3157 Will, married person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

3158 Will, unmarried person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

Nationwide

The generic forms listed below are intended for use in any state. Use them if

specific forms under state headings in the catalog are not available. They should

be adapted in compliance with local statutes and practice.

AFFIDAVIT (also see—PROOF)

P 117 Blank affidavit

93 Power of attorney is in full force and effect, Web Only

3039 Affidavit of domicile (residence) and debts to obtain distribution from

decedent’s estate, Web Only

ASSIGNMENT (also see—LANDLORD & TENANT)

T 225 General purpose, with power of attorney

W 483 Rent, Web Only

AUTHORIZATION

T 3129 Authorization to release medical and hospital records

BANKRUPTCY

1031 Proof of claim, pkg of 48, with instructions, Web Only

BILL OF SALE (also see—BULK TRANSFER)

310 Automobiles, airplanes, vehicles, assignments, ind. corp., Web Only

M 187 Business, bill of sale, affid. of title, restriction cl.

100 Chattels, personal property, with affidavit. ind. corp., Web Only

T 1100 Chattels, personal property, without affid., short form

P 1101 Personal property, with affidavit, attractive border, Web Only

BINDER (see—CONTRACT)

BUILDING OR CONSTRUCTING (see—CONTRACT)

BULK TRANSFER—SALE OF A BUSINESS (UCC)

W 82 Contract for Sale of Business, ind. or corp.

W 81 Bill of Sale of Business-affidavit of title, restriction clause

CONFIDENTIALITY AGREEMENT

3002 Confidentiality agreement, intellectual property, Web Only

CONSULTING AGREEMENT

3001 Consulting agreement, Web Only

CONTRACT

155 Blank, for any subject, double sheet, Web Only

W 82 Business, sale of, bulk transfers (UCC) ind., corp.

A 348 Construction, small, owner and contractor

A 188 Construction, similar to A 348 (more comprehensive)

T 152 Contractor’s proposal & contract, Web Only

T 87 Equipment lease, Web Only

M 107 Partnership, Articles of

B 122 Real estate, binder (purchase offer)

3124 Real estate installment land contract, Web Only

T 487 Real estate, option to purchase, Web Only

3125 Real estate, sale of, office, commercial, multi-family residential

premises,Web Only

3100 Retail instalment contract (security agreement), Truth in Lending,

Reg. Z

3123 Affidavit subordination, non-disturbance and attornment agreement,

Web Only

3105 Use and occupancy agreement, seller remains, Web Only

CORPORATION

3133 Affidavit of missing certificate, Web Only

Central Record for all Corporate Clients

T 5102 Corporate record tickler

Printed Minutes & By-Laws

5160 Blank state model business corporation act

5160PDF Same as fillable pdf, $18.00. Call 800 221-2972, press 1 to order

5161 Blank state membership corporation

5162 Blank state professional corporation, by-laws only

Securities Assignments, Powers and Authorization Transfer

C 229 Stock power, assign, separate from certif., irrevocable

C 133 Stock or bond power irrecovable, ASEF form 133

EQUIPMENT LEASE (see—CONTRACT)

GIFT

3205 Deed of gift with acknowledgment, 1 p., Web Only

LANDLORD & TENANT

P 193 Sub-lease, any purpose, (incl. coop. apt.)

114 Lease, any purpose, double page, large space, Web Only

P 172 Lease, any purpose, short form, single sheet

Residential leases

58 Apartment house rules, comprehensive, Web Only

59 Apartment lease, comprehensive, large building, rules, Web Only

62 Apartment and single family house lease, comprehensive, rules,

Web Only

A 55 Apartment, rules, guaranty, acknowledgments, double sheet

T 186 Apartments in 2-5 family dwelling, single sheet

T 48 Apartment, moderate coverage, single sheet

T 202 Apartment, month-to-month

A 303 Apartment, furnished, double sheet, Web Only

A 101 Condominium unit

A 495 House, furnished or unfurnished, moderate coverage

3120 House lease with option to buy, plain English, furnished or

unfurnished, Web Only

T 313 Seasonal, house or apartment, vacation residence, etc., single page

315 Weekly vacation residence lease, plain English, furnished, Web Only

3105 Use and occupancy agreement, seller remains, Web Only

Commercial leases

65 Apartment house laundry service license, Web Only

66 Apartment house laundry service lease, Web Only

3210 Office license agreement, Web Only

A 880 Lease of business premises, marginal headings

Miscellaneous forms related to Leases

71 Application for lease of apartment, references, Web Only

3119 Rental binder and deposit receipt, Web Only

T 308 Notice to quit, 10 days where no landlord/tenant relationship exists,

Web Only

3141 Lead paint disclosure, lease of residence

3142 Lead paint disclosure, sale of residence

P 586 Assignment of lease with assumption

W 281 Assignment of lease

W 483 Assignment of rent, Web Only

3126 Collateral assignment of leases and rents, Web Only

T 195 Extension of lease

T 3112 Inventory of furniture and furnishings (lease rider or checklist)

T 215 Surrender of lease

3105 Use and occupancy agreement, seller remains , Web Only

Law Forms — Nationwide

LEAD PAINT REGULATIONS BOOKLET

Protect Your Family From Lead In Your Home, and Disclosure Form must be

distribted to tenants or purchasers by: a) lessor of houses and apartments, b)

sellers of houses, condoes and co-op apartments. Renovators of pre-1978 houses

and common areas in multi-family buildings must distribute booklets.

Lead Paint Booklet 16 pp. 8

⁄2" x 5

⁄2", 3 color, 50 lb. offset paper.

3140 English 25–$26.25 100–$65.00

250–$142.50 500–$260.00

Imprinting— 1000 or more, request quote, 800 221-2972, ext. 1695.

Disclosure Forms 2-part carbonless 8

⁄2" x 11"

3141 Lease of residence 25–$23.00 50–$16.50 100–$19.00

300–$49.90 500–$61.10

3142 Sale of residence 25–$23.00 50–$16.50 100–$19.00

300–$49.90 500–$61.10

Larger quantites—request quote

LIMITED LIABILITY COMPANY

Model Operating Agreements for Any State

Prepared by Victor S. Elgort, Esq., Norris McLaughlin & Marcus, P. A. Revised in 2016.

Six forms included plus a Comparative Features List to help you choose the

appropriate form:

a) Single member, member governed

b) Single member, manager governed

c) Basic one class percentage interests

d) Standard form one class percentage interests

e) Long form, one class, percentage interests, buy sell provisions

f) Long form, two members, one class, percentage interests, buy sell

provisions

— NEW Fillable PDF with LLC name and state in fields, sent via email, Cat. No. 5159PDFZ, if

purchased without a kit, $18.00. Comes with LLC Kit if you order the Cat. No. with printed

forms.

— Paper forms, Cat. No. 5159, if purchased without a kit, $17.50. Comes with LLC kit if you

order the Cat. No. with printed forms and specify paper forms instead of fillable pdf forms.

NOTE

D 485 Promissory note, non-negotiable, interest

P 607 Prom. note, witness, large space, 7

⁄8"x 11" litho border

B 1000N Serial note, accel., 4 notes on each sheet, perforated, endorser waives

presentment, demand, notice of protest & of dishonor on back:

individual, 100 on pad

OPTION (see—CONTRACT)

PARTNERSHIP

M 107 Partnership contract

POWER OF ATTORNEYS

93 Affidavit, power of attorney is in full force and effect, Web Only

3130 Enumerated powers, durable or springing, affidavit, Web Only

W 50 Full powers, unrestricted, disability cl., double page

M 113 General purpose, with large space for powers, Web Only

T 462 Revocation of power of attorney

3131 Revocation of power of attorney, Web Only

3177 Will, married person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

3178 Will, unmarried person, affidavit of subscribing witnesses, execution

instructions, 8 pp., Web Only

PROOF

3211 Affidavit and proof of claim, Web Only

REAL ESTATE (also see—CONTRACT—LANDLORD & TENANT—STATEMENT)

3121 Certificate of Non-Foreign Satus, IRC Sec. 1445, Ind., Web Only

RELEASE

B 110 General release, individual

B 111 General release, corparation, Web Only

T 112 General release, joint tortfeasor’s clause, ind., corp., Web Only

3005 Image release, Web Only

P 618 Seaman’s release

STATEMENT

T 194 Title closing state., settlement figures, real estate

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UCC

Security Agreements

A 77 In the nature of a chattel mortgage (UCC)

T 84 In the nature of a conditional sales contracts (UCC)

85 Assignment of a security agreement, Web Only

Bulk Transfer: Sale of a Business

W 82 Contract for sale of business: individual or corporation

W 81 Bill of sale of business: affidavit of title: restriction clause

WILL

P 3202 Living Will

M 95 Living will with healthcare direction

3177 Will, married person, affidavit of subscribing witnesses, execution

instructions, Web Only

3178 Will, unmarried person, affidavit of subscribing witnesses, execution

instructions, Web Only

M 1683 Will, 100% rag content, 4 pg., large blank space

Numerical — Law Forms

T 27 Mortgage note, NYBTU 8011, 11-98

T 29 Claim & notice of intent to sue blank Transit

Authority, 6-83

A 35 Store, loft, office, margin captions, full cls., dbl.

sheet, 11-98

M 40 Non-statutory, commercial (business, finance &

real estate), prepared by Donovan & Giannuzzi,

LLP, 4 pp., 9-10

P 42 Appointment of agent to control disposition of

remains, GBL §453, 2 pps, 4-07

M 44 Statutory, durable, without affidavit of attorney,

4 pp., 6-21

T 48 Apartment, moderate coverage, single sheet, 7-19

M 50 Full powers, unrestricted, disability cl., double

page, 7-04

M 51 Statutory, durable, affidavit of attorney, 6 pp.,

7-19

A 54 House, furnished or unfurnished, most complete.

brokerage cl., 7-19

A 55 Apartment, rules, guaranty, acknowledgments,

4pps., 7-19

M 56 Lease of a regulated apartment, modern and

comprehensive, 13pps., 7-19

M 57 Lease of an unregulated apartment, modern and

comprehensive, 13pps., 8-21

B 69 Subpoena, blank Ct., duces tecum, witness’ stip.

remain subj. to call, 2-09

P 70 Health care proxy, PHL 2980, 4-91

B 72 Blank Court, duces tecum, witness’ stip. remain

subj. to call, CPLR 2305(b), 9-03

X 74 Conducting business as partners (corp. may be a

partner), 4-10

A 77 Security agreement in the nature of a chattel

mortgage, 10-01

W 81 Bill of Sale of Business- affidavit of title, restriction

clause, 11-98

W 82 Contract for Sale of Business, ind. or corp., 10-01

T 84 Security agreement in the nature of a conditional

sales contracts (UCC), 1964

T 85 Security agreement assignment, ind., corp., 1966

T 87 Equipment lease, 1978

M 95 Health care proxy with living will directives, 7-94

101 Lease of a condominium unit, 8 pps., 12 sets,

$53.80, 7-19, 12 uncollated sets, 8 pages

B 106 Blank Ct. summons, with notice, 4-94

M 107 Partnership, Articles of, 11-98

T 112 General release, joint tortfeasor’s clause, ind.,

corp., 11-98

M 113 Power of attorney, general purpose, with large

space for powers, 11-98

P 117 Blank affidavit

B 119 Notice to tenant, 3 days, non-payment of rent,

English/Spanish: public assistance statement, 7-19

T 120 Property execution, blank ct., notice to garnishee,

4-21

B 122 Purchase offer real estate, standard form, plain

English, 9-81

M 123 Cooperative apt., sales contract, financing

condition, 7-01

125 Contract of sale, residential real estate, jt. bar

association form, 6 pps., 11-00, 16 forms, $47.80

130 Property condition disclosure statement, space for

answers, 4 pps. letter size, CRPL §462, $41.30,

3-02

T 132 Demand for service of complaint, CPLR 3012 (b),

1973

C 133 Stock or bond power irrecovable, ASEF form 133,

7-70

T 140 Affidavit, show cause order, vacate eviction

judgment, 4-73

T 141 Post card, matrimonial action, 5-99

B 151 Affidavit, Summons or subpoena, personal or alt.

service, ind. or corp., military service statement,

1-95

T 156 Blank Court, bill of costs (with CPLR sections),

1-95

T 158 Summons, divorce action, blank relief, UD-1, 9-95

T 163 Supreme Ct., summons with notice, annulment,

1-95

A 167 Mechanic’s notice of: ind., part., corp. (N.Y.C.

form), 9-96

T 173 Divorce and child support summary form,

UCS-111, 12-01

T 176 Cancellation of partnership certificate, 11-98

A 185 Store, Gilsey form security clause, double sheet,

7-04

T 186 Apartments in 2-5 family dwelling, single sheet,

7-19

M 187 Business, bill of sale, affid. of title, restriction cl.,

11-98

A 188 Construction, similar to A 348 (more

comprehensive), 11-78

P 193 Sub-lease, any purpose, (incl. coop. apt.), 12-14

T 194 Title closing state., settlement figures

T 195 Extension of lease, 12-14

X 201 Conducting business under trade name,

individual, 4-10

T 202 Apartment lease, from month to month, 7-19

T 206b Original petition, non-payment business, 1-95

T 206d Original petition non-payment dwelling, 1-95

T 207b Original notice of petition, non-payment business,

7-19

T 207d Original notice of petition, non-payment dwelling,

7-19

X 211 Original notice of petition, holdover-dwell. or

business, 7-19

T 212 Eviction notice post card, holdover, Civil Ct., 7-03

T 214 Acknowledgement, indiv. corp., ptnr., witness &

LLC, 11-98

T 215 Surrender of lease, 2-78

T 216 Eviction notice post card, non payment Civil Ct.,

11-06

T 225 General purpose, with power of attorney, 11-98

T 231 Mechanic’s lien, satisfaction of, ind., corp., 11-98

B 242 Satisfaction of judgment, whole or partial, blank

ct., 12-98

X 245 Confession of judgment, ind., corp.: blank court,

1973

B 250 Affidavit, Add. mailing of summons, CPLR 3215:

default judg., bl ct., 1-87

W 251 Questions for corp. debtor, blank ct., 1963

T 275 Satisfaction of mortgage, NYBTU 8035, 11-98

T 278 Executor’s NYBTU 8005-A, short form, 11-98

W 281 Assignment of lease, 11-98

A 283 Mortgage long form, NYBTU 8014, 11-98

A 289 Bargain & sale, no covenant, NYBTU 8006,

long form, 11-98

A 291 Bargain & sale, covenant, NYBTU 8007, long

form, 11-98

A 293 Quitclaim, NYBTU 8009, long form, 11-98

M 294 Quitclaim, long form D, 11-98

W 295 Release of part of the mortgaged premises:

NYBTU 8034, 11-98

T 304 Notice to tenant by certified mail: 5 days, 7-19

B 307 Notice to tenant, 30 days to terminate monthly

tenancy or month to month, 6-00

T 309 Omnibus notice to terminate tenancy: 30, 60 or 90

days, 7-19

T 313 Seasonal, house or apartment, vacation residence

etc. single page guarantee, acknowledgments, 7-19

X 317 Consent. change (substitution) of attorney, blank

ct., 11-98

B 323 Civil Court, judgment on inquest or after trial,

1974

326 Rent stabilization rider, pkg. of 25, $33.00, 9-19

326BX Same, box of 250, $195.00, 7-14

T 327 Apartment, stabilized, substantial coverage, single

sheet, 7-19

330 Renewal lease (RTP-8), pkg. of 25, 3pt. carbonless

sets, $32.90, 9-19

330BX Same, box of 250, quantity pricing, $181.50, 9-19

T 341 Cancellation of business certificate, individual,

11-98

A 348 Construction, small, owner and contractor, 1-78

T 354 Questions for 3rd party, blank ct., 1974

T 366 Notice of lien for common charges, Condominium

Act, RPL §339-z, 339-aa, 11-98

T 372 Lis Pendens, consent & order to cancel,

foreclosure, 9-74

T 386 Mechanic’s lien on public improvements, 8-94

T 394 Recognition agreement, joint bar committee form,

4-94

T 407 Information subpoena, Civil Ct., to judgment

debtor or to witness, 8-12

T 409 Affirmation, order to show cause, non-compliance

with subpoena, Civil Ct., 11-77

X 411 Subpoena to judgment debtor, blank ct., 1976

T 416 Restraining notice to garnishee, CPLR 5222,

blank ct., 1-09

X 417 Information subpoena, blank Ct., to judgment

debtor or to witness, 8-12

T 420 Affirmation, order to show cause, non-compliance

with subpoena, blank ct., 11-77

T 422 Exemption claim form, CPLR 5222-a(b), serve two

with restraining notice & exemption claim form,

1-09

T 426 Notice to judgment debtor, a natural person,

CPLR 5222 (d) & (e) blank ct., 1-09

T 439 Income execution, Blank Court, 4-21

X 444 Original petition non-payment dwelling or

business, 1-95

X 445 Original notice of petition, non-payment dwell. or

bus., 7-19

T 448 Original petition holdover, dwelling or business,

1-95

T 449 Original notice of petition, holdover, dwelling or

business, 7-19

T 454 Statement of client’s rights and responsibilities, 2-19

A 455 Retainer agreement, Matrimonial Rules, based

on clauses approved by the NY Chapter of the

American Academy of Matrimonial Lawyers and

the Family Law Sections NYSBA Bar Association,

2-01

T 462 Revocation of power of attorney, 7-10

T 471 Notice of appeal, 1973

T 472 Release & receipt to executor or administrator,

with receipt, ind., corp., 11-98

D 485 Promissory note, non-negotiable, interest

T 487 Real estate, option to purchase, 11-98

P 490 Attorney’s written letter of engagement, 22 NYCRR

1215, 3-02

T 510 Original petition, any grounds, 1-95

T 511 Original notice of petition, any grounds, 7-19

Numerical List of Paper Forms

Online forms are not listed here. Go to blumberglegalforms.com and enter Cat. No. without letter prefix in search box.

Law Forms — Numerical

T 519 Judgment, evict. & rent, default, non-pay. dwell.

or bus., 1973

T 530 Judgment of eviction, default, after trial or inquest,

holdover, dwelling or business, 1974

B 537 Note of issue, certificate of readiness, all

departments, 9-95

B 538 Closing state., contingent fee, App. Div. 1st & 2nd

Dept., 3-05

T 540 Retainer, straight 33

⁄

%, App. Div., 1st & 2nd

Dept. Statement as to Retainer, 3-14

T 541 Statement as to retainers, App. Div., 1st & 2nd

Dept., blank fee. also condemnation, 3-14

B 547 Receipt post card for OCA statements of retainer

and closing, 1-96

T 549 Statement as to retainer, App. Div., 1st & 2nd

Dept., 3-14

T 579 Debt or claim against decedent estate, with

affidavit

P 586 Assignment of lease with assumption, 11-98

T 600 Answer, blank ct., 1977

T 601 Application for index number, CPLR 8018(a)2,

7-03

P 607 Prom. note, witness, large space, 7

⁄

”x 11” litho

border

P 618 Seaman’s release

628 Purchase & sale record of second hand articles,

3-pt., bound book of 50 sets, $37.00, 5-95

629 Same, 2-pt., 4-80, $34.70

630 Dealers record of purchases: precious metals,

1–$62.20, 10–$55.30 ea.

T 638 Discontinuance of assumed name, certificate of,

corp., 7-04

P 666 Combined note and mortgage, short form, 11-98

P 678 Warranty, basic covenants, short form A, 11-98

P 688 Warranty, full covenants, short form A, 11-98

T 689 Bargain & sale, no covenant, NYBTU 8001, short

form, 11-98

T 691 Bargain & sale, covenant, NYBTU 8002, short

form, 11-98

A 880 Lease, bus., loft or office, marginal headings

P 889 Lease, house furnished or unfurnished, 5-86

P 890 Lease, apartment, short form, 5-86

A 901 Deed, warranty, full covenants, ind., corp., 4-83

M 911 Will, affidavit of executor and witness, self proving

affidavit, 5-87

M 915 Lease, apartment, comprehensive form, 5-86

M 916 Contract of sale, standard, 9-93

M 974 Mortgage, subordinate, ind. or corp., 5-86

B 1000N Serial note, accel., 4 notes on each sheet, perforat-

ed, endorser waives presentment, demand, notice

of protest & of dishonor on back: individual, 100

on pad

T 1100 Bill of sale, chattels, personal property, without

affid., short form, 9-03

P 1122 Real estate, sale of land, shortest form, 11-98

T 1161 Endorsed compl., 22 NYCRR 214.3(b), 11-93

T 1165 Uniform transcript of judgment: blank ct., 5-99

T 1183 Claim, notice of intent to sue any public auth. GML

50, 6-81

M 1220 General power of attorney, disability clause. Conn.

Statutory Short Form Power of Attorney Act, 5-11

M 1251 Apartment, furnished or unfurnished, 9-11

M 1252 House, furnished or unfurnished, 9-11

T 1406 Original petition, non-payment, dwelling or

business, 1-95

T 1407 Original notice of petition, non-payment, dwell.,

or business, 7-19

T 1410 Original petition, holdover, dwelling or business,

1-95

T 1411 Original notice of petition, holdover, dwell. or

business, 7-19

T 1412 Judgment, evict. & rent, default, non-pay., dwell.

or bus., 1974

T 1423 District Court, judgment on inquest or after trial,

1974

T 1600 Notice of intent to claim, motor vehicle, MVAIC,

5-04

T 1624 Satisfaction of mortgage, 1 side recording, 11-98

T 1664 Serve with formal compl., Suffolk, 22 NYCRR

212.6(d), 2-92

M 1683 Will, 4 pg., large blank space, 9-91

P 1688 Warranty, full covenants, 1 side recording A,

11-98

P 1693 Quitclaim, 1 side recording D, 11-98

A 1893 House lease, 6-94

3011 Professional pet protection agreement – Pet Trust,

10 pp, $27.00

3100 Retail installment contract, $39.50, 10-82

T 3112 Inventory of furniture and furnishings (lease rider

or checklist), 6-94

T 3121 Certificate of Non-Foreign Satus, IRC Sec. 1445,

Ind., 6-85

T 3129 Authorization to release medical and hospital

records, 10-85

3140 Lead paint booklet, English, 12-12

3141 Lead paint disclosure, lease of residence, 9-96

3142 Lead paint disclosure, sale of residence, 9-96

P 3202 Living Will, 5-85

T 5102 Corporate record tickler, 10-10

MINUTES & BY-LAWS

5150 New York Business Corporation (BCL), $10.25,

1998

5152 New York Professional Corporation (Art. 15),

$10.25

5153 New York Not-For-Profit Corporation (N-PCL),

$24.30, 7-17

5154 New York LLC Operating Agreements, $18.90

5159 Nationwide LLC Operating Agreements, etc.,

$18.90

5160 Blank state model business corporation act, $10.25

5161 Blank state membership corporation, $10.25

5162 Blank state professional corp., by-laws only,

$10.25

5169 Missouri business corporation, $10.25

5170 California business corporation, $10.25

5171 Connecticut business corporation, $10.25

5172 Delaware business corporation, $10.25

5173 Florida business corporation, $10.25

5174 New Jersey business corporation, $10.25

5175 Pennsylvania business corporation, $10.25

5176 Texas business corporation, $10.25

5177 Illinois business corporation, $10.25

5178 Michigan business corporation, $10.25

5179 Georgia business corporation, $10.25

4-22