22 NYCRR 212.6

(a) The summons shall state the district and location of the court in which the action is brought, as well as the names of the parties, and shall comply with all the provisions of the UDCA applicable to summonses.

(b) Where an action is brought in any district where there are subdivisions designated as parts for a particular location, there shall also be set forth in the caption of the summons the name of the part, as, for example, "Third District, Great Neck Part."

(c) The following form shall be used in a case in which:

(1) the cause of action is for money only;

(2) the summons is served by personal delivery to the defendant within Nassau or Suffolk County; and

(3) a formal complaint is not served therewith:

DISCTRICT COURT OF THE CITY OF ___________________

_____________________ District

Index No. ______

___________________________

)

Plaintiff,

)

SUMMONS

)

Plaintiff's Residence

-against-

)

Address:

)

)

The basis of the venue

Defendant,

)

designated is:

)

______________________________________

To the above named defendant:

YOU ARE HEREBY SUMMONED and required to appear in the District Court of the COUNTY OF..... District, at the office of the Clerk of the said Court at..... in the County of....., State of New York, either (i) by serving an answer [FNa1] within 20 days after service of this summons upon you, exclusive of the day of service, upon plaintiff's attorney, at the address stated below, or if there is no attorney, upon the plaintiff at the address stated above, or (ii) by appearing at the clerk's office within 20 days after service of this summons upon you, exclusive of the day of service, by having the clerk of the court endorse your answer upon this summons; upon your failure to answer, judgment will be taken against you for the sum of $..... with interest thereon from the..... day of....., 19....., together with the costs of this action.

Dated: the ____ day of ____, 19____

__________________

Statement of the nature and

Attorney(s) for Plaintiff

substance of plaintiff's

Post-Office Address

cause of action:

Telephone Number

__________________

[FNa1] You need not physically go to court to serve an answer under option (i). However, you are required to file a copy of your answer together with proof of service with the clerk of the district in which the action is brought within 10 days after service of the answer.

(d) In a case in which a formal complaint is annexed to the summons, the following form of summons shall be used:

DISCTRICT COURT OF THE CITY OF ___________________

_____________________ District

Index No. ______

___________________________

)

Plaintiff,

)

SUMMONS

)

Plaintiff's Residence

-against-

)

Address:

)

)

The basis of the venue

Defendant,

)

designated is:

)

______________________________________

To the above named defendant:

YOU ARE HEREBY SUMMONED and required to appear in the District Court of the COUNTY OF_____, _____ District, at the office of the Clerk of the said Court at _____ in the County of _____, State of New York, by serving an answer to the annexed complaint upon plaintiff's attorney, at the address stated below, or if there is no attorney, upon the plaintiff, at the address stated above, within the time provided by law as noted below; upon your failure to answer, judgment will be taken against you for the relief demanded in the complaint, together with the costs of this action.

Dated: the ____ day of ____, 19____

__________________

Attorney(s) for Plaintiff

Post-Office Address

Telephone Number

NOTE: The law or rules of court provide that:

(a) if this summons is served by its delivery to you, or (for a corporation) an agent authorized to receive service, personally within the County of..... you must answer within 20 days after such service; or

(b) if this summons is served otherwise than as designated in subdivision (a) above, you are allowed 30 days to answer after the proof of service is filed with the Clerk of this Court.

(c) You are required to file a copy of your answer together with proof of service with the clerk of the district in which the action is brought within 10 days of the service of the answer.