Fillable Form Aa-33 - Traffic Violations Bureau Appeal Form (Page 2 of 2) in pdf

RECORDS REVIEWED:

The Appeals Board does NOT rehear cases, accept new evidence, or weigh the credibility of the witnesses. Exhibits that are received into evidence at the hearing

will become part of the appeal record unless the only issue on appeal is the penalty imposed. If you want copies of the hearing exhibits for your own records, you

must submit a Freedom of Information Law (FOIL) request to the DMV FOIL OFFICE at: 6 EMPIRE STATE PLAZA, ALBANY, NY 12208. Information about

submitting FOIL requests is available online at: dmv.ny.gov.

APPEAL ARGUMENTS:

In the space below, state your arguments and explain your reasons for filing the appeal. Attach additional pages, if necessary.

By law, personal appearances and oral arguments are NOT permitted on appeal. If a hearing transcript is produced, you will have 30 DAYS to submit final

arguments from the date the transcript is sent to you. You will be notified in writing of the outcome of your appeal. If you win on appeal and the Appeals

Board dismisses the conviction, the fine will be refunded.

________________________________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________

READ THE STATEMENT BELOW. SIGN YOUR NAME. WRITE THE DATE THAT YOU SIGNED THIS FORM. (By law, no appeal shall be

reviewed if it is sent more than 30 days after the conviction date.)

I AFFIRM UNDER PENALTY OF PERJURY THAT ALL THE INFORMATION ON THIS FORM AND ALL SUPPORTING DOCUMENTS ARE

TRUE, AND THAT NO PRIOR APPEAL HAS BEEN FILED WITH RESPECT TO THIS TICKET.

Appellant Signature

_________________________________________________________

Date ___________________________

HAVE YOU:

Have you paid your fine to the Traffic Violations Division? Even if you file an appeal, you must pay your fine or your license will be suspended.

Have you submitted your appeal form and appeal fee for each TVB ticket within 30 days of the TVB conviction date?

Have you enclosed a $10.00 non-refundable appeal fee by check or money order for each TVB ticket you want to appeal?

Have you checked the appropriate box on page one indicating whether you are appealing the guilty verdict and the penalty or the penalty only?

Have you explained the reasons for filing your appeal above? Have you explained your reasons for requesting a stay on page one?

Have you signed and dated your appeal form above?

Have you made copies of your appeal form, appeal fee, and proof of mailing for your records?

dmv.ny.gov

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AA-33 (3/15)

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Form Aa-33 - Traffic Violations Bureau Appeal Form Page 2

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