"Request for Extension of Time to File Appeal (And Request for Hearing Recording)" - New York City Download Pdf
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"Request for Extension of Time to File Appeal (And Request for Hearing Recording)" - New York City

Request for Extension of Time to File Appeal (And Request for Hearing Recording) is a legal document that was released by the New York City Office of Administrative Trials and Hearings - a government authority operating within New York City.

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  • Released on January 4, 2019;
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Appeals Unit
66 John St., 10th Floor
New York, NY 10038
REQUEST FOR EXTENSION OF TIME TO FILE APPEAL
(AND REQUEST FOR HEARING RECORDING)
Use this form to request more time to appeal, and, if you also want, the audio recording of the hearing in order
to review it before appealing. The Appeals Unit will notify you as to whether your request for more time is
granted or denied. If granted, your additional time will begin once you are notified.
You must also complete the “PROOF OF PAYMENT” and “PROOF OF SERVICE” sections on page 2 of this form.
Information About the Summons(es) and the Person Completing This Form
If a representative is listed, the Hearings Division will mail the determination on this request to the representative at the representative’s address. If
a representative is not listed, the Hearings Division will mail the determination to the address listed below.
__________________________________________________________
Summons Number(s) (use an extra page if needed):
____________________________
______________________________
Name on Summons(es):
Name of Requestor:
____________________________________________
___________________
Relationship to Respondent
:
(if applicable)
_________________________________
Mailing Address:
(Registered Representatives must attach Authorization to Appear Form)
____________________________________
_________________________________
City, State:
Mailing Address:
_____________________________________
____________________
________
Zip Code:
City, State:
Zip Code:
______________________________
______________________________
Telephone Number:
Telephone Number:
_________________________________
_________________________________
Email Address:
Email Address:
Extension Request (You must check one box)
This is a first request filed within thirty (30) days of the date of the Hearing Officer’s decision, or within thirty-five (35)
days if the hearing decision was mailed.
All other requests will only be granted on good cause shown. You must explain below the reason for this request.
You may also attach any documents in support.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Additional Request for Audio Recording (Check box if you also want the audio recording)
I am also requesting a copy of the AUDIO RECORDING OF THE HEARING be provided to me for purposes of filing my
appeal, along with my extension.
Please note that the Hearings Division prepares audio recordings at the rate of 25 cents per CD for recordings that are
picked up and $3.00 for recordings that are mailed. The Hearings Division will contact you with the total cost for
preparing the audio once your request is processed. There is no cost for recordings that are emailed. Please indicate
how you would like the audio recording provided to you.
 Email the audio, at no cost, to the email address(es) provided above. (Please note that some audio recordings are
too large to attach to an email. In such instances, the audio will either have to be picked up or mailed.)
 I will pick up the CD(s), at the cost of 25 cents per CD.
 Mail the CD(s), for $3.00, to the address provided above.
(TURN OVER. YOU MUST COMPLETE THE NEXT PAGE)
App17 appeals - uniform appeal extension 1_04_19
Appeals Unit
66 John St., 10th Floor
New York, NY 10038
REQUEST FOR EXTENSION OF TIME TO FILE APPEAL
(AND REQUEST FOR HEARING RECORDING)
Use this form to request more time to appeal, and, if you also want, the audio recording of the hearing in order
to review it before appealing. The Appeals Unit will notify you as to whether your request for more time is
granted or denied. If granted, your additional time will begin once you are notified.
You must also complete the “PROOF OF PAYMENT” and “PROOF OF SERVICE” sections on page 2 of this form.
Information About the Summons(es) and the Person Completing This Form
If a representative is listed, the Hearings Division will mail the determination on this request to the representative at the representative’s address. If
a representative is not listed, the Hearings Division will mail the determination to the address listed below.
__________________________________________________________
Summons Number(s) (use an extra page if needed):
____________________________
______________________________
Name on Summons(es):
Name of Requestor:
____________________________________________
___________________
Relationship to Respondent
:
(if applicable)
_________________________________
Mailing Address:
(Registered Representatives must attach Authorization to Appear Form)
____________________________________
_________________________________
City, State:
Mailing Address:
_____________________________________
____________________
________
Zip Code:
City, State:
Zip Code:
______________________________
______________________________
Telephone Number:
Telephone Number:
_________________________________
_________________________________
Email Address:
Email Address:
Extension Request (You must check one box)
This is a first request filed within thirty (30) days of the date of the Hearing Officer’s decision, or within thirty-five (35)
days if the hearing decision was mailed.
All other requests will only be granted on good cause shown. You must explain below the reason for this request.
You may also attach any documents in support.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Additional Request for Audio Recording (Check box if you also want the audio recording)
I am also requesting a copy of the AUDIO RECORDING OF THE HEARING be provided to me for purposes of filing my
appeal, along with my extension.
Please note that the Hearings Division prepares audio recordings at the rate of 25 cents per CD for recordings that are
picked up and $3.00 for recordings that are mailed. The Hearings Division will contact you with the total cost for
preparing the audio once your request is processed. There is no cost for recordings that are emailed. Please indicate
how you would like the audio recording provided to you.
 Email the audio, at no cost, to the email address(es) provided above. (Please note that some audio recordings are
too large to attach to an email. In such instances, the audio will either have to be picked up or mailed.)
 I will pick up the CD(s), at the cost of 25 cents per CD.
 Mail the CD(s), for $3.00, to the address provided above.
(TURN OVER. YOU MUST COMPLETE THE NEXT PAGE)
App17 appeals - uniform appeal extension 1_04_19
RESPONDENTS ONLY – YOU MUST COMPLETE PROOF OF PAYMENT AND PROOF OF SERVICE BELOW
1) You MUST check “Yes” to one of the choices below in order to appeal:
The penalty has been paid in full or payment of the full penalty has been waived by the
YES
NO
agency.
The penalty must be paid in full within 30 days of the date of the hearing decision, or 35 days if the decision was
mailed; otherwise your appeal will be rejected. Filing this request does not extend the time to pay the penalty.
Vehicle for Hire and Taxi Cases: Payment or waiver is not required if the summons is for a violation of a law or
regulation enforced by the Taxi and Limousine Commission.
Consumer Cases: Even if full payment of the penalty has been waived, if the Hearing Officer’s decision orders the
payment of restitution, the respondent must deposit the amount of restitution with the Department of Consumer
Affairs.
Payment Plans: If the respondent has entered into a payment plan with the agency responsible for collecting payment
of the fines or penalties, you must attach a copy of the payment plan.
The respondent is eligible to complete Community Service instead of paying a civil penalty, has
YES
NO
contacted the OATH Help Center to opt for community service, and has completed intake.
For cases eligible for Community Service under the Criminal Justice Reform Act only, the respondent does not have to pay
the penalty or complete Community Service in order to appeal so long as the respondent has contacted and completed
intake with the Help Center. (Contact information for the Help Center is on the back of the hearing decision.)
The respondent is requesting a waiver of payment of the penalty because it will be a
financial hardship to pay while the appeal is being decided.
YES
NO
You MUST attach proof of hardship, such as the first two pages of the respondent’s Federal tax return, and explain
below how paying the penalty now would be a financial hardship for the respondent.
____________________________________________________________________________________
____________________________________________________________________________________
2a) I am sending a copy of the request to (check the box next to the agency that you are sending the copy of the request to):
Building Cases:
Sanitation, Recycling, Posting
Fire Code Cases (including
Open Alcohol Container and
Health Code, Restaurant,
Dept. of Buildings
& Abandoned Vehicle Cases:
fireworks):
Public Urination Cases
Food Vendor, & SRO Cases
Administrative Enforcement
Department of Sanitation
FDNY Legal Enforcement Unit
New York City Police Dept.
DOHMH General Counsel
th
th
Unit 280 Broadway, 5
Floor
Bureau of Legal Affairs
Bureau of Legal Affairs
Attn: Legal Bureau
42-09 28th Street, 14
Floor CN-30
th
th
New York, NY 10007
125 Worth Street, 7
Floor
9 Metrotech Center, 4
Floor
1 Police Plaza, Room 1406
Long Island City, NY 11101-4132
New York, NY 10013
Brooklyn, NY 11201
New York, NY 10007
Air, Noise, Water, RTK,
Transportation Code &
Parks Department, Hudson
Public Pay Telephone Cases:
Finance Cases
HazMat & Sewer Cases:
Newsrack Cases:
River Park & Battery Park City
DOITT Customer Service
(including Sheriff’s Office):
DEP General Counsel
Dept. of Transportation
Cases:
Coordinator
NYC Department of Finance
th
59-17 Junction Blvd, 19
Fl.
c/o Asst. Commissioner, HIQA
Parks Dept. Counsel’s Office
Public Pay Telephones
Legal Affairs Division
th
th
Flushing, NY 11373-5108
55 Water Street, 7
Floor
The Arsenal, 830 5
Avenue
75 Park Place, 9th Fl.
345 Adams Street, 3rd Floor
New York, NY 10041
New York, NY 10065
New York, NY 10007
Brooklyn, NY 11201
Markets Cases:
Consumer & General Vendor Cases:
Landmarks Cases:
For-Hire Vehicle & Taxi Cases:
Business Integrity Comm., Gen. Counsel
Dept. of Consumer Affairs, General Counsel
Landmarks Preservation Commission
NYC Taxi & Limousine Commission
th
th
100 Church Street, 20
Floor
42 Broadway, 8
Floor
Municipal Bldg., 1 Centre St., 9th Fl., North.
Falchi Bldg., 31-00 47th Ave.
New York, NY 10007
New York, NY 10004
New York, NY 10005
Long Island City, NY 11101
The request for an extension of time will be rejected unless you send a copy of the completed request, including any attachments,
to the enforcement agency responsible for the summons(es). Note: If the respondent is requesting a hardship waiver, do not send
the enforcement agency copies of the proof of hardship.
2b) You can prove that you sent a copy of the request to the agency by checking the box next to the enforcement agency in Step
2a above AND completing and signing the statement below.
I
_____________________________, RESIDING AT
_________________________________________, CERTIFY
[print your name]
[your address]
UNDER PENALTY OF PERJURY THAT I AM AUTHORIZED TO SUBMIT THIS REQUEST, THAT TO THE BEST OF MY KNOWLEDGE ALL
INFORMATION I INCLUDED ON THIS FORM AND IN THE ATTACHMENTS, IF ANY, IS TRUE, AND THAT ON
__________________
[
]
date
I SENT A COPY OF THIS REQUEST TO THE ENFORCEMENT AGENCY RESPONSIBLE FOR THE SUMMONS(ES) AT ITS ADDRESS LISTED
ABOVE BY PLACING IT IN A U.S. POSTAL SERVICE MAILBOX OR BY OTHER MAILING SERVICE.
YOUR SIGNATURE:
____________________________
ENFORCEMENT AGENCIES ONLY
Enforcement agencies must attach a separate affirmation indicating service on the respondent.
1_04_19
App17 appeals - uniform appeal extension
New York City Office of Administrative Trials and Hearings New York City Legal Forms United States Legal Forms

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