APPEAL FORMS

Docket Support Unit Revised: March 4, 2003

United States District Court

Southern District of New York

Office of the Clerk

U.S. Courthouse

500 Pearl Street, New York, N.Y. 10007-1213

Date:

In Re:

-vCase #: ( )

Dear Litigant,

Enclosed is a copy of the judgment entered in your case.

Your attention is directed to Rule 4(a)(1) of the Federal Rules of Appellate Procedure, which requires

that if you wish to appeal the judgment in your case, you must file a notice of appeal within 30 days of the

date of entry of the judgment (60 days if the United States or an officer or agency of the United States is a

party).

If you wish to appeal the judgment but for any reason you are unable to file your notice of appeal

within the required time, you may make a motion for an extension of time in accordance with the provision

of Fed. R. App. P. 4(a)(5). That rule requires you to show “excusable neglect” or “good cause” for your

failure to file your notice of appeal within the time allowed. Any such motion must first be served upon the

other parties and then filed with the Pro Se Office no later than 60 days from the date of entry of the judgment

(90 days if the United States or an officer or agency of the United States is a party).

The enclosed Forms 1, 2 and 3 cover some common situations, and you may choose to use one of

them if appropriate to your circumstances.

The Filing fee for a notice of appeal is $5.00 and the appellate docketing fee is $250.00 payable to

the “Clerk of the Court, USDC, SDNY” by certified check, money order or cash. No personal checks are

accepted.

J. Michael McMahon, Clerk of Court

by: 

, Deputy Clerk

Case 1:07-cv-03363-GBD Document 39-2 Filed 08/20/2007 Page 1 of 5
APPEAL FORMS

Docket Support Unit Revised: March 4, 2003

United States District Court

Southern District of New York

Office of the Clerk

U.S. Courthouse

500 Pearl Street, New York, N.Y. 10007-1213

------------------------------------------------------------X

 |

 | NOTICE OF APPEAL

 |

 -V- |

 |

 | civ. ( )

 |

------------------------------------------------------------X

 

Notice is hereby given that 

(party)

hereby appeals to the United States Court of Appeals for the Second Circuit from the Judgment [describe it]

entered in this action on the day of , .

 (day) (month) (year)

 

(Signature)

 

(Address)

 

(City, State and Zip Code)

Date: ( ) - 

 (Telephone Number)

Note: You may use this form to take an appeal provided that it is received by the office of the Clerk of the

District Court within 30 days of the date on which the judgment was entered (60 days if the United States or

an officer or agency of the United States is a party).

FORM 1 

Case 1:07-cv-03363-GBD Document 39-2 Filed 08/20/2007 Page 2 of 5
APPEAL FORMS

Docket Support Unit Revised: March 4, 2003

United States District Court

Southern District of New York

Office of the Clerk

U.S. Courthouse

500 Pearl Street, New York, N.Y. 10007-1213

------------------------------------------------------------X

 |

 | MOTION FOR EXTENSION OF TIME

 | TO FILE A NOTICE OF APPEAL

 -V- |

 |

 | civ. ( )

 |

------------------------------------------------------------X

 

Pursuant to Fed. R. App. P. 4(a)(5), respectfully

(party)

requests leave to file the within notice of appeal out of time. 

(party)

desires to appeal the judgment in this action entered on but failed to file a

 (day)

notice of appeal within the required number of days because:

[Explain here the “excusable neglect” or “good cause” which led to your failure to file a notice of appeal within the

required number of days.]

 

(Signature)

 

(Address)

 

 (City, State and Zip Code)

Date: ( ) - 

 (Telephone Number)

Note: You may use this form, together with a copy of Form 1, if you are seeking to appeal a judgment and

did not file a copy of Form 1 within the required time. If you follow this procedure, these forms must be

received in the office of the Clerk of the District Court no later than 60 days of the date which the judgment

was entered (90 days if the United States or an officer or agency of the United States is a party).

FORM 2 

Case 1:07-cv-03363-GBD Document 39-2 Filed 08/20/2007 Page 3 of 5
APPEAL FORMS

Docket Support Unit Revised: March 4, 2003

United States District Court

Southern District of New York

Office of the Clerk

U.S. Courthouse

500 Pearl Street, New York, N.Y. 10007-1213

------------------------------------------------------------X

 |

 | NOTICE OF APPEAL

 | AND

 -V- | MOTION FOR EXTENSION OF TIME

 |

 | civ. ( )

 |

------------------------------------------------------------X

1. Notice is hereby given that hereby appeals to

(party)

the United States Court of Appeals for the Second Circuit from the judgment entered on .

[Give a description of the judgment]

2. In the event that this form was not received in the Clerk’s office within the required time 

 respectfully requests the court to grant an extension of time in

(party)

accordance with Fed. R. App. P. 4(a)(5).

a. In support of this request, states that

(party)

this Court’s judgment was received on and that this form was mailed to the

(date)

court on .

 (date)

 

(Signature)

 

(Address)

 

(City, State and Zip Code)

Date: ( ) - 

 (Telephone Number)

Note: You may use this form if you are mailing your notice of appeal and are not sure the Clerk of the

District Court will receive it within the 30 days of the date on which the judgment was entered (60 days if

the United States or an officer or agency of the United States is a party).

FORM 3

Case 1:07-cv-03363-GBD Document 39-2 Filed 08/20/2007 Page 4 of 5
APPEAL FORMS

Docket Support Unit Revised: March 4, 2003

United States District Court

Southern District of New York

Office of the Clerk

U.S. Courthouse

500 Pearl Street, New York, N.Y. 10007-1213

------------------------------------------------------------X

 |

 | AFFIRMATION OF SERVICE

 |

 -V- |

 |

 | civ. ( )

 |

------------------------------------------------------------X

 

I, , declare under penalty of perjury that I have

served a copy of the attached 

 

upon 

 

whose address is: 

 

Date: 

 New York, New York

 

(Signature)

 

(Address)

 

 (City, State and Zip Code)

FORM 4

Case 1:07-cv-03363-GBD Document 39-2 Filed 08/20/2007 Page 5 of 5