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Sharpe Motion For Prompt Hearing And Determination - New York
| Sharpe Motion For Prompt Hearing And Determination Form. This is a New York form and can be used in Western District District Court Federal . |
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WDNY2/03Revised 0 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NEW YORK HOW TO FILE YOUR SOCIAL SECURITY SHARPE MOTION IMPORTANT NOTICE: Do NOT File this Motion Unless at Least 120 Days Has Elapsed Since You Requested a Hearing (Or Since Your Hearing Was Held But No Decision Has Yet Issued)IMPORTANT: You must accurately fill out the correct number of forms and submit them to the Court. If you fill out theforms incorrectly and/or send the wrong number of forms, they will be re turned to you. Check the Western Districts web site at www.nywd.uscourts.gov for copies of many of the Courts forms and other useful information.I. MOTION 1. Fill out the motion form completely, supplying all requested information in the spaces provided. You will need to submit a total of four copies of the form: one for the Court, one for the respondent, one for the United States Attorney, and one for the United States Attorney General. Be sure to sign the motion. Keep one copy for your own personal file. 2. Attach a copy of the letter from the Social Security Administration advising you of your right to file this motion to each copy of the motion form. 3. Be sure to provide all docket numbers and courts of any prior federal ca ses regarding this claim, if any.II. FILING FEE In order to file the completed motion and other necessary papers, you must pay a $30.00 filing fee by personal check, money order, certified check, or official check made out to "Clerk, Unit ed States District Court". If you file in person, you may pay in cash. You may also file a motion to proceed in forma pauperis (as a poor person); if you qualify, you will not be required to pay the filing fee.III. CIVIL COVER SHEET Fill out the "Civil Cover Sheet" according to these instructions: 1(a). Print your name as Plaintiff; 1(b). Print "Commissioner of Social Security" as Defendant; 1(c). Print "Pro Se" under Plaintiffs Attorney; 1(d). Put "United States Attorney, Buffalo, New York" as Defendants Attorney; 2. Basis for Jurisdiction: check Box No. 2: U.S. Defendant;<<<<<<<<<********>>>>>>>>>>>>> 2 3. Citizenship of Principal Parties: leave blank; 4. Cause of Action: Write "42 U.S.C. 405(g)" and "Sharpe Motion" 5. Nature of Suit: Write "Miscellaneous Civil" in the space after the words "(Put an X in one box only). DO NOT CHECK ANY BOXES AT ALL. 6. Origin: check Box No. 1: Original Proceeding; 7. Requested in Complaint: leave blank; 8. Related Case(s) if any: if you have ever filed another federal lawsuit relating to social security benefits, write the name of the court and the docket number; and 9. Date and sign your name followed by "Pro Se" on the last line. IV. MAILING INSTRUCTIONS Finally, bring or mail all of the above papers to either one of the addresses below: United States District Court Clerk United States District Court Clerk 304 U.S. Courthouse 2120 U.S. Courthouse 68 Court Street 100 State Street Buffalo, New York 14202-3498 Rochester, New York 14614-1387 (716) 551-4211 or (716) 551-5759 (585) 263-6263V. GENERAL INFORMATION 1. Except for your motion, you must send a copy of every legal paper that you send to the Court to the respondents attorney as well. The Court will serve only your motion, not any subsequent papers. You may obtain a form for your affidavit/affirmation of such service from the Clerks Office or the Western District web site. 2. You do not need to attach "exhibits" to your original motion and its copies other than a copy of the letter you received advising you of your right to file this motion because your hearing and/or determination has been unreasonably delayed. You must submit enough copies for all the copies of the motion. 3. You must notify the Clerks Office and all respondents (or their attorneys) of any address changes. Failure to do so may result in dismissal of your motion pursuant to Local Rule of Civil Procedure 5.3(d). The Local Rules are available on the Western District web site. 5. The Clerk of Court will not file your motion unless it conforms to these instructions and to these forms pursuant to Local Rules of Civil Procedure 5.2 and 5.3. 2 <<<<<<<<<********>>>>>>>>>>>>> 3 WDNY2/03Revised 0 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NEW YORK (Print your name) Petitioner, _____-CV-___________ vs. SHARPE MOTION FOR A PROMPT HEARING AND DETERMINATIONCOMMISSIONER OF SOCIAL SECURITY, Respondent I, , respectfully state:1. This is a motion for an Order directing the Social Security Administration to provide me with a prompt hearing and/or decision and to pay me interim benefits pending the resolution in my case. See Sharpe v. Sullivan , 1990 WL 4016 (S.D.N.Y. 1990), and Sharpe v. Heckler, 1985 WL 2898 (S.D.N.Y. 1985).2. I requested a hearing before an Administrative Law Judge on 3. (Applicant should check one of the following statements.) ____ No hearing has as yet been scheduled. I believe that this delay i s unreasonable. ____ No decision has as yet been scheduled. I believe that this delay is unreasonable.4. I have been informed by the Social Security Administration of my right to request this Order by letter dated 5. I reside at: 6. My telephone number is: 7. My social security number is: 1 <<<<<<<<<********>>>>>>>>>>>>> 48. Respondent is the Commissioner of Social Security, and as such, has full power and responsibility over disability benefits under the Social Security Act as amended. 9. My disability or disabilities are: 10. My disability or disabilities began on 11. I have /have not filed other actions in U.S. Courts relating to my efforts to obtain Social Security Disability Benefits. If other actions were filed, they are listed below (attach a separate sheet if necessary):Court Name Docket Number Date Filed Date Case Closed (if applicable) WHEREFORE, I respectfully request that: (a) Respondent be ordered to provide me with a prompt hearing of and/or decision on my claim;(b) Applicant should check one of the following: Yes ____ or No _____: Respondent be ordered to pay me interim benefits pending this hearing and/or decision. (c) Such further relief as may be just and proper under the circumstances of this case.I declare under penalty of perjury that the foregoing is true and correct. Date: Signature (Print Name Below) 2
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