State Court Notice of Appeal
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NOTICE OF APPEAL

(Supreme Court of the State of New York — [County] County)

1. CAPTION

text
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF [COUNTY_NAME]
Index No. [INDEX_NUMBER]

[PLAINTIFF_NAME],
Plaintiff,

-against-

[DEFENDANT_NAME],
Defendant.

Attorney Information

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[ATTORNEY_NAME], Esq. (NY Bar No. [BAR_NUMBER])
[LAW_FIRM_NAME]
[ADDRESS]
[City], New York [ZIP]
Telephone: [PHONE] | Facsimile: [FAX]
Email: [EMAIL]
Attorney for Appellant [CLIENT_NAME]

2. NOTICE OF APPEAL

Notice is hereby given that [CLIENT_NAME], [trial court role], appeals to the Appellate Division of the Supreme Court of the State of New York, [FIRST/SECOND/THIRD/FOURTH] Judicial Department, from the [judgment/order] of the Supreme Court, [County] County (Hon. [JUDGE_NAME], J.S.C.), entered on [ENTRY_DATE] and served with notice of entry on [NOTICE_OF_ENTRY_DATE], which [brief description].

3. TIMELINESS AND RELATED MOTIONS

This notice is served and filed within 30 days after service of the order/judgment with notice of entry pursuant to CPLR 5513(a). Post-decision motions affecting the time to appeal (CPLR 5513(b)) were [FILED/NOT FILED]; if filed, they were decided on [DATE].

4. ISSUES INTENDED TO BE RAISED (SUMMARY)

  1. [ISSUE_ONE]
  2. [ISSUE_TWO]
  3. [ISSUE_THREE]

5. RECORD ON APPEAL

Appellant will proceed on [full record/appendix method] in accordance with 22 NYCRR Part 1250 and will ensure settlement of the transcript pursuant to CPLR 5525. The informational statement required by 22 NYCRR 1250.3 is being filed contemporaneously/within 15 days.

6. RELIEF REQUESTED

Appellant seeks reversal, modification, or vacatur of the appealed order/judgment, together with costs, disbursements, and such other relief as the Appellate Division deems proper.

7. SIGNATURE BLOCK

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Dated: [CITY], New York, [DATE]


[ATTORNEY_NAME], Esq.
Attorney for Appellant [CLIENT_NAME]

8. TO: (SERVICE LIST)

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[List names and addresses of all parties/counsel served]

9. PROOF OF SERVICE

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STATE OF NEW YORK )
COUNTY OF [COUNTY] ) ss.:

[SERVER_NAME], being duly sworn, deposes and says:

  1. I am over 18 years of age and not a party to this action.
  2. On [SERVICE_DATE], I served the within NOTICE OF APPEAL by ☐ NYSCEF electronic service ☐ First-Class Mail ☐ Overnight Delivery ☐ Personal Service upon:
    - [RECIPIENT_NAME], [ADDRESS]

[SERVER_NAME]

Sworn to before me this
___ day of ____, 20__


Notary Public

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