UCS-CCR4New YorkFillable

Affirmation of Facts and Sale of Account by Original Creditor

New York Civil Courts · Civil Lawsuits

Copy of the court's form from nycourts.gov, taken October 21, 2026. See it on the court's site ↗

Affirmation by a servicer for an original creditor in a consumer credit case setting out the facts of the debt and the sale of the account, from the creditor's business records.

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