Intheblanks form required for any matter originating and electronically filed in Supreme or Surrogate's Courts in Richmond County. Confidentiality statement: Position the confidentiality statement near the bottom of the cover sheet or in a footer.Place this fax cover sheet confidentiality statement in a prominent place. For example, you can put it near the bottom of the cover sheet or in a footer. The information contained in this facsimile transmission is privileged and confidential and is intended only for the use of the recipient listed above. Use short, descriptive labels to convey the information. Note: This form must be downloaded to your device in order to be filled out properly. It must be opened in Adobe Acrobat Reader. A fax cover sheet includes a 'Confidential' notice, indicating that the fax is meant solely for the designated recipient. The documents accompanying this transmission may contain confidential information that is legally protected.