PROFESSIONAL LICENSING APPEAL – NEW YORK

CAPTION

Before [Agency/Board] (or Article 78 in Supreme Court if applicable)
[LICENSEE NAME], Petitioner,
v.
[AGENCY/BOARD NAME], Respondent.

INTRODUCTION

• Appeal/challenge to [Denial/Discipline/Suspension/Revocation] of [License Type] issued [DATE].

JURISDICTION AND TIMELINESS

• Filed within [X] days under [agency rule/statute]; if proceeding via Article 78, filed within four (4) months of the final determination after exhaustion of administrative remedies.

VENUE

• Article 78: Supreme Court, [County of petitioner residence/where agency is located], CPLR Art. 78.

ISSUES PRESENTED

• [Issue 1]
• [Issue 2] (as needed)

STATEMENT OF FACTS

• Chronology of application/discipline, notices, hearings, findings.

ERRORS AND ARGUMENT

• Lack of substantial evidence; arbitrary/capricious actions; errors of law under [cite].
• Due process concerns if notice/opportunity to be heard was deficient.

RELIEF REQUESTED

• Reverse/modify the decision; reinstate or grant license; remand for further proceedings; stay requested [Yes/No].

EXHIBITS

• Determination/order; transcript excerpts; affidavits; key record exhibits.

SERVICE

• Serve agency and Attorney General (if Article 78) per CPLR requirements; include affidavit of service.

SIGNATURE

[Name, Bar No.]
[Address, Email, Phone]
Counsel for [LICENSEE]