STATE OF NEW YORK
COUNTY OF ___________________________
CITY COURT of the CITY OF ______________
_______________________________________
THE PEOPLE OF THE STATE OF NEW YORK

                                                                                              NOTICE OF APPEAL
                            vs
                                                                                              Docket No. ________

                                              Defendant
_______________________________________

PLEASE TAKE NOTICE THAT THE ABOVE NAMED ____________________________
                                                                                                      (Defendant/Appellant)
HEREBY APPEALS TO THE ___________________________ COUNTY COURT FROM
                                                        (name of County)
THE CONVICTION ENTERED ON __________________________ AND FROM EVERY
                                                                            (date)
PART THEREOF.
 
 

DATED: ___________________           _________________________________________
                                                               (Signature of Appellant/Defendant)

                                                                 _________________________________________
                                                                (Address of Appellant/Defendant)

                                                                  _________________________________________

TO:  ___________________________
        (Prosecutor)

        ______________________________
           (Address of Prosecutor)

        ___________________________