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SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF SUFFOLK
DENNIS M. BROWN, County Attorney
for the COUNTY OF SUFFOLK,
Plaintiff/Claiming Authority,
-against-
a ______________, VIN NO.
______________________,
______________________,
Defendant(s),
STIPULATION
IT IS HEREBY STIPULATED AND AGREED, by and between the plaintiff/claiming
authority, DENNIS M. BROWN, County Attorney for the County of Suffolk (the “Plaintiff”) and
the defendant, ___________________ (the “defendant”), as follows:
WHEREAS, the Plaintiff seized a _________________, VIN No.
_____________________ (the “Vehicle”), on _______________, as a result of
_______________________ arrest;
WHEREAS, the parties hereby stipulate and agree as follows:
1. No party hereto is an infant or incompetent person for whom a committee has
been appointed and no person not a party has an interest in the subject matter of this action.
2. All parties consent to the Court’s jurisdiction.
3. The Vehicle, presently in the custody of the Plaintiff, is hereby forfeited by the
defendant, to the Suffolk County Attorney’s Office under the authority of Suffolk County Code
Article II of Chapter 420; Article III of Chapter 818; Article IV of Chapter 818 and/or Article VI
of Chapter 818 and Article 13-A of the C.P.L.R., for distribution pursuant to the provisions of
that Article, and the defendant hereby grant all of his/her rights, title and interest in said vehicle
to the Plaintiff.
YEAR and MAKE
VIN NO.
TITLED OWNER'S NAME
TITLED OWNER'S NAME
YEAR and MAKE
VIN NO.
TITLED OWNER'S NAME
VIN NO.
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4. The defendant, states that he/she has made a diligent search and to the best of
his/her knowledge he/she cannot find the original title to named vehicle. The defendant further
state that he/she has not previously signed, donated, sold or promised said title or vehicle to any
other person or entity.
5. The Plaintiff hereby releases the defendant of all liability under Suffolk County
Code Article II of Chapter 420; Article III of Chapter 818; Article IV of Chapter 818 and/or
Article VI of Chapter 818 and Article 13-A of the C.P.L.R. for the seizure of the vehicle
immediately upon execution of this agreement.
6. This Stipulation of Settlement may be filed without any further notice.
Dated: Hauppauge, New York
___________________
_____________________________
________________________
DENNIS M. BROWN
Subscribed and sworn to before me this
_____ day of ___________, 20___
______________________________
Notary Public, State of
TITLED OWNER'S NAME
VIN NO.
TITLED OWNER'S NAME; SIGN
ABOVE LINE