# NOTICE OF APPEAL

**[NY][CPLR] Appeal to Appellate Division Pursuant to CPLR Article 55**

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**{{TRIAL COURT NAME}}**
**COUNTY OF {{COUNTY}}**

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{{Appellant Name}},
{{Role in Trial Court - Plaintiff/Defendant}},

-against-

{{Appellee Name}},
{{Role in Trial Court}},

Index No. {{Number}}

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## NOTICE OF APPEAL

PLEASE TAKE NOTICE that {{Appellant Name}}, {{role}}, hereby appeals to the Appellate Division, {{First/Second/Third/Fourth}} Department, from:

{{Description of order/judgment - e.g., "the order of this Court (Hon. [Judge Name], J.S.C.), dated [date] and entered [date] in the Office of the Clerk of [County] County, which [granted defendant's motion to dismiss / denied plaintiff's motion for summary judgment / etc.]"}}

The Notice of Entry of the {{order/judgment}} was served on {{Appellant Name}} on {{date}}.

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## ISSUES ON APPEAL

The issues to be raised on appeal include, but are not limited to:

1. {{Issue 1 - e.g., "Whether the trial court erred in granting defendant's motion to dismiss for failure to state a claim under CPLR Section 3211(a)(7)"}}

2. {{Issue 2 - e.g., "Whether the trial court violated CPLR Section 2219(a) by failing to state grounds for the decision or specify papers considered"}}

3. {{Issue 3 - e.g., "Whether the trial court's ruling deprived appellant of due process by [specify]"}}

4. Such other issues as may appear from the record on appeal.

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{{#if stay_requested}}
## STAY OF ENFORCEMENT

PLEASE TAKE FURTHER NOTICE that appellant intends to move for a stay of enforcement of the {{order/judgment}} pending determination of this appeal pursuant to CPLR Section 5519.
{{/if}}

{{#if poor_person_relief}}
## POOR PERSON RELIEF

PLEASE TAKE FURTHER NOTICE that appellant intends to move for leave to proceed as a poor person pursuant to CPLR Section 1101 and for assignment of counsel.
{{/if}}

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Dated: {{Date}}

Respectfully submitted,

_________________________
{{Your Signature}}
{{Your Name}}
{{Pro Se / Attorney for Appellant}}
{{Address}}
{{Phone}}
{{Email}}

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## CERTIFICATE OF SERVICE

I hereby certify that on {{date}}, I served a true and correct copy of the foregoing Notice of Appeal upon:

{{Opposing Party/Counsel Name}}
{{Address}}

by {{method of service - NYSCEF electronic filing / first-class mail / certified mail, return receipt requested / personal service}}.

_________________________
{{Your Signature}}
{{Your Name}}

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**TO:**
{{Opposing Counsel/Party Name}}
{{Address}}

**AND TO:**
Clerk of the Appellate Division
{{First/Second/Third/Fourth}} Department
{{Address}}

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**Authorities:**
- CPLR Section 5515 (notice of appeal - form and content)
- CPLR Section 5513 (time to appeal - 30 days from service of notice of entry)
- CPLR Section 5519 (stays pending appeal)
- CPLR Section 1101 (poor person relief)
- CPLR Section 5701 (appeals as of right; permission required)

**Next Steps:**
- Perfect appeal within time specified by Appellate Division (typically 9 months)
- Order transcripts (CPLR Section 5525)
- Prepare record on appeal (CPLR Section 5526)
- File appellant's brief per Appellate Division rules