Form APP19 "Request for Extension of Time to Respond to an Appeal (And Request for Hearing Recording)" - New York City (Haitian Creole)

This is a legal form that was released by the New York City Office of Administrative Trials and Hearings - a government authority operating within New York City.

The document is provided in Haitian Creole. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 23, 2017;
  • The latest edition provided by the New York City Office of Administrative Trials and Hearings;
  • Easy to use and ready to print;
  • Available in French;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form APP19 by clicking the link below or browse more documents and templates provided by the New York City Office of Administrative Trials and Hearings.

ADVERTISEMENT
ADVERTISEMENT

Download Form APP19 "Request for Extension of Time to Respond to an Appeal (And Request for Hearing Recording)" - New York City (Haitian Creole)

Download PDF

Fill PDF online

Rate (4.8 / 5) 71 votes
Appeals Unit
66 John St., 10th Floor
New York, NY 10038
DEMANN POU PLIS TAN POU REPONN YON KONTESTASYON
AK / OSWA ANREGISTREMAN ODYANS
ITILIZE FOM SA A POU MANDE:
PLIS TAN POU REPONN YON KONTESTASYON; OSWA
ANREJISTREMAN ODYO ODYANS LA POU W KA KOUTE LI AVAN OU REPONN YON KONTESTASYON.
DEFANDÈ YO DWE RANPLI FÒM NAN EPI:
SÈVI (POSTE) YON KOPI BAY AJANS APLIKASYON LALWA KI RESPONSAB POU SITASYON AN (YO);
DEPOZE YON KOPI AK OATH HEARINGS DIVISION NAN ADRÈS KI ANWO A.
AJANS APLIKASYON LALWA YO DWE RANPLI FÒM NAN EPI:
SÈVI (POSTE) YON KOPI BAY DEFANDÈ A;
DEPOZE YON KOPI AK OATH HEARINGS DIVISION NAN ADRÈS KI ANWO A.
Enfòmasyon Konsènan Sitasyon a (yo) ak Moun Ki Ranpli Fòm Sa a
Si gen yon reprezantan, Hearings Divizyon pral poste detèminasyon pou demann sa a bay reprezantan an nan adrès reprezantan an. Si li pa gen yon
reprezantan, Hearings Division pral poste detèminasyon an nan adrès ki anba a.
__________________________________________________
Nimewo Sitasyon (yo) (itilize yon paj an plis si ou bezwen plis plas):
__________________________
________________________
Non ki sou Sitasyon an (yo):
Non moun k ap fè Demand la:
____________________________________________
_____________________
Relasyon li ak Defandè a
(si sa aplikab):
____________________________________
Adrès Postal:
(Reprezantan ki Anrejistre yo dwe tache Fòm Otorizasyon pou Prezante)
______________________________________
___________________________________
Vil, Eta:
Adrès Postal:
___________________________________
____________________
_________
Kòd Postal:
Vil, Eta:
Kòd Postal:
________________________________
________________________________
Nimewo Telefòn:
Nimewo Telefòn:
___________________________________
____________________________________
Adrès Imèl:
Adrès Imèl:
Tcheke ti bwat la si yo te sispann oswa anile lisans Defandè a (si sa apwopriye):
Demann Sa a Se Pou (tcheke youn):
Plis tan pou depoze yon repons pou yon kontestasyon. Demann nan dwe gen prèv ki montre l ap enposib pou depoze
kontestasyon an atan oswa lòt eksplikasyon. Eksplike:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Yon anrejistreman odyo odyans la. N ap refize demann sa a si nou resevwa li nan plis pase 30 jou apre dat moun k ap
konteste a te bay kontestasyon an, oswa plis pase 35 jou si yo te voye kontestasyon an pa lapòs.
 M ap vin chèche CD yo pou 25 santim pou chak CD
 Voye CD yo pa lapòs, pou $3.00, nan adrès ki anwo a
 Voye ant
Apre yo fin ba ou anrejistreman odyo a, ou pral genyen yon lòt 30 jou pou sèvi ak depoze repons ou pou kontestasyon
an. Tanpri, n ap fè w konnen Hearings Division prepare anrejistreman odyo pou 25 santim pa CD pou anrejistre ou vin
pran ou menm epi $3.00 pou anrejistreman yo voye ba ou pa lapòs. Hearings Division pral kontakte ou ak pri total pou
prepare odyo a pou ou apre nou fin trete demann ou a. Ou p ap peye senk kòb pou anrejistreman yo voye pa lapòs.
(TOUNEN PAJ LA. OU DWE RANPLI PAJ APRE A)
App19 appeals uniform response extension 10_23_17-Haitian Creole
Appeals Unit
66 John St., 10th Floor
New York, NY 10038
DEMANN POU PLIS TAN POU REPONN YON KONTESTASYON
AK / OSWA ANREGISTREMAN ODYANS
ITILIZE FOM SA A POU MANDE:
PLIS TAN POU REPONN YON KONTESTASYON; OSWA
ANREJISTREMAN ODYO ODYANS LA POU W KA KOUTE LI AVAN OU REPONN YON KONTESTASYON.
DEFANDÈ YO DWE RANPLI FÒM NAN EPI:
SÈVI (POSTE) YON KOPI BAY AJANS APLIKASYON LALWA KI RESPONSAB POU SITASYON AN (YO);
DEPOZE YON KOPI AK OATH HEARINGS DIVISION NAN ADRÈS KI ANWO A.
AJANS APLIKASYON LALWA YO DWE RANPLI FÒM NAN EPI:
SÈVI (POSTE) YON KOPI BAY DEFANDÈ A;
DEPOZE YON KOPI AK OATH HEARINGS DIVISION NAN ADRÈS KI ANWO A.
Enfòmasyon Konsènan Sitasyon a (yo) ak Moun Ki Ranpli Fòm Sa a
Si gen yon reprezantan, Hearings Divizyon pral poste detèminasyon pou demann sa a bay reprezantan an nan adrès reprezantan an. Si li pa gen yon
reprezantan, Hearings Division pral poste detèminasyon an nan adrès ki anba a.
__________________________________________________
Nimewo Sitasyon (yo) (itilize yon paj an plis si ou bezwen plis plas):
__________________________
________________________
Non ki sou Sitasyon an (yo):
Non moun k ap fè Demand la:
____________________________________________
_____________________
Relasyon li ak Defandè a
(si sa aplikab):
____________________________________
Adrès Postal:
(Reprezantan ki Anrejistre yo dwe tache Fòm Otorizasyon pou Prezante)
______________________________________
___________________________________
Vil, Eta:
Adrès Postal:
___________________________________
____________________
_________
Kòd Postal:
Vil, Eta:
Kòd Postal:
________________________________
________________________________
Nimewo Telefòn:
Nimewo Telefòn:
___________________________________
____________________________________
Adrès Imèl:
Adrès Imèl:
Tcheke ti bwat la si yo te sispann oswa anile lisans Defandè a (si sa apwopriye):
Demann Sa a Se Pou (tcheke youn):
Plis tan pou depoze yon repons pou yon kontestasyon. Demann nan dwe gen prèv ki montre l ap enposib pou depoze
kontestasyon an atan oswa lòt eksplikasyon. Eksplike:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Yon anrejistreman odyo odyans la. N ap refize demann sa a si nou resevwa li nan plis pase 30 jou apre dat moun k ap
konteste a te bay kontestasyon an, oswa plis pase 35 jou si yo te voye kontestasyon an pa lapòs.
 M ap vin chèche CD yo pou 25 santim pou chak CD
 Voye CD yo pa lapòs, pou $3.00, nan adrès ki anwo a
 Voye ant
Apre yo fin ba ou anrejistreman odyo a, ou pral genyen yon lòt 30 jou pou sèvi ak depoze repons ou pou kontestasyon
an. Tanpri, n ap fè w konnen Hearings Division prepare anrejistreman odyo pou 25 santim pa CD pou anrejistre ou vin
pran ou menm epi $3.00 pou anrejistreman yo voye ba ou pa lapòs. Hearings Division pral kontakte ou ak pri total pou
prepare odyo a pou ou apre nou fin trete demann ou a. Ou p ap peye senk kòb pou anrejistreman yo voye pa lapòs.
(TOUNEN PAJ LA. OU DWE RANPLI PAJ APRE A)
App19 appeals uniform response extension 10_23_17-Haitian Creole
POU DEFANDÈ YO SÈLMAN - OU DWE RANPLI PRÈV SÈVIS ANBA LA A
1a) M ap voye yon kopi demann nan bay (tcheke ti bwat ki akote non ajans w ap voye yon kopi demann nan bay li):
Ka Bilding yo:
Asenisman, Resiklaj, Afichaj
Ka Kòd Dife (ak fe atifis ladan):
Dosye Boutèy Alkòl ki Louvri
Ka Kòd Sante, Restoran,
Dept. of Buildings
ak Machin ki Abandone:
FDNY Legal Enforcement Unit
New York City Police Dept.
Vandè Manje, ak SRO
Administrative Enforcement
Department of Sanitation
Bureau of Legal Affairs
Attn: Legal Bureau
DOHMH General Counsel
th
th
th
Unit 280 Broadway, 5
Floor
Bureau of Legal Affairs
9 Metrotech Center, 4
Floor
1 Police Plaza, Room 1406
42-09 28th Street, 14
Floor CN-30
th
New York, NY 10007
125 Worth Street, 7
Floor
Brooklyn, NY 11201
New York, NY 10007
Long Island City, NY 11101-4132
New York, NY 10013
Ka Lè, Bri, Dlo, RTK, HazMat
Ka Kòd Transpò ak Kyòs Jounal:
Ka Minisipalite Depatman Pak, Vil Hudson
Ka Telefòn Piblik:
ak Dlo Ize:
Dept. of Transportation
River ak Battery:
DOITT Customer Service Coordinator
DEP General Counsel
c/o Asst. Commissioner, HIQA
Parks Dept. Counsel’s Office
Public Pay Telephones
th
th
th
59-17 Junction Blvd, 19
Floor
55 Water Street, 7
Floor
The Arsenal, 830 5
Avenue
75 Park Place, 9th Fl.
Flushing, NY 11373-5108
New York, NY 10041
New York, NY 10065
New York, NY 10007
Ka Mache:
Ka Konsomatè ak Vandè Jeneral:
Ka Sit Istorik:
Ka pou Machin ki Disponib pou travay ak
Business Integrity Comm., Gen. Counsel
Dept. of Consumer Affairs, General Counsel
Landmarks Preservation Commission
Taksi yo:
th
th
100 Church Street, 20
Floor
42 Broadway, 8
Floor
Municipal Bldg., 1 Centre St., 9th Fl., North.
NYC Taxi & Limousine Commission
New York, NY 10007
New York, NY 10004
New York, NY 10005
Falchi Bldg., 31-00 47th Ave.
Long Island City, NY 11101
N ap bay yon demann pou ekstansyon refi amwenske ou voye yon kopi konplè demann nan, ki gen nenpòt atachman, bay ajans
aplikasyon lalwa ki reponsab pou sitasyon an (yo).
1b) Pou bay prèv ou te voye yon kopi demann nan bay ajans la, tcheke ti bwat ki akote non ajans aplikasyon lalwa a nan Etap 2a
anwo a EPI ranpli ak siyen deklarasyon ki anba la a.
MWEN SE
_____________________________, M AP VIV NAN
_____________________________________,
[ekri non ou an lèt detache]
[adrès ou]
EPI MWEN SÈTIFYE AVÈK POSIBLITE SANKSYON POU FO TEMWAYAJ, MWEN GEN OTORIZASYON POU SOUMÈT DEMANN SA A, EPI
SELON TOUT SA MWEN KONNEN TOUT ENFÒMASYON MWEN METE SOU FÒM SA A AK NAN DOKIMAN YO KI VINI AK LI YO, SI
GENYEN, SE VERITE EPI NAN DAT
______________MWEN TE VOYE YON KOPI DEMANN SA A BAY AJANS APLIKASYON LALWA
[
]
dat
KI RESPONSAB POU SITASYON AN (YO) NAN ADRÈS LI KI ANWO A KOTE MWEN TE DEPOZE LI NAN YONB BWAT LÈT SÈVIS LAPÒS
AMERIKEN OSWA AK LÒT SÈVIS POSTAL.
SIYATI OU:
____________________________
AJANS APLIKASYON LALWA YO SÈLMAN
Ajans aplikasyon lalwa yo dwe kote yon afimasyon separe ki endike yo te voye dokiman an bay defandè a.
App19 appeals uniform response extension 10_23_17-Haitian Creole
Page of 2