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_______________ Court of the State of New York County of __________________ NOTICE OF APPEAL Index No.: PLEASE TAKE NOTICE that (insert your name) __________________________________ hereby appeals to the Appellate Division of the Supreme Court of the State of New York, Second Judicial Department, from a (insert judgment, order, decree, etc.) __________________________ of the ______________________________ Court, __________________________ County, dated _____________________________. Dated: ________________, New York ________________ ___, 200___ Yours, etc., Signature (Print Name) (Address) (Telephone Number) To: (Insert below the name and address of the clerk of the trial court and the names and addresses of all opponents) 2002 © American LegalNet, Inc.