UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT AGENCY APPEAL PRE-ARGUMENT STATEMENT (FORM C-A) 9 CAPTION: APPLICATION FOR ENFORCEMENT 2. PLEASE TYPE OR PRINT. AGENCY NAME: 9 PETITION FOR REVIEW 1. SEE NOTICE ON REVERSE. 3. STAPLE ALL ADDITIONAL PAGES. AGENCY NO.: DATE THE ORDER UPON WHICH REVIEW OR ENFORCEMENT IS SOUGHT WAS ENTERED BELOW: ALIEN NO : (Immigration Only) DATE THE PETITION OR APPLICATION WAS FILED: Is this a cross-petition for review / cross-application for enforcement? 9 YES 9 NO E-mail: Contact Information for Petitioner(s) Attorney: Contact Information for Respondent(s) Attorney: JURISDICTION OF THE COURT OF APPEALS (provide U.S.C. title and section): Counsel's Name: Address: Telephone No.: Fax No.: Counsel's Name: Address: Telephone No.: Fax No.: E-mail: APPROX. NUMBER OF PAGES IN THE RECORD: APPROX. NUMBER OF EXHIBITS IN THE RECORD: Has this matter been before this Circuit previously? If Yes, provide the following: Case Name: 2d Cir. Docket No.: 9 Yes 9 No Reporter Citation: (i.e., F.3d or Fed. App.) ADDENDUM "A": COUNSEL MUST ATTACH TO THIS FORM: (1) A BRIEF, BUT NOT PERFUNCTORY, DESCRIPTION OF THE NATURE OF THE ACTION; (2) THE RESULT BELOW; AND (3) A COPY OF ALL RELEVANT OPINIONS/ORDERS FORMING THE BASIS FOR THIS PETITION FOR REVIEW OR APPLICATION FOR ENFORCEMENT. ADDENDUM "B": COUNSEL MUST ATTACH TO THIS FORM: (1) THE RELIEF REQUESTED; (2) A LIST OF THE PROPOSED ISSUES; AND (3) THE APPLICABLE APPELLATE STANDARD OF REVIEW FOR EACH PROPOSED ISSUE. PART A: STANDING AND VENUE STANDING PETITIONER / APPLICANT IS: VENUE COUNSEL MUST PROVIDE IN THE SPACE BELOW THE FACTS OR CIRCUMSTANCES UPON WHICH VENUE IS BASED: 9 9 AGENCY 9 OTHER PARTY NON-PARTY (SPECIFY STANDING): IMPORTANT. COMPLETE AND SIGN REVERSE SIDE OF THIS FORM. Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com PART B: NATURE OF ORDER UPON WHICH REVIEW OR ENFORCEMENT IS SOUGHT (Check as many as apply) TYPE OF CASE: ADMINISTRATIVE REGULATION/ RULEMAKING BENEFITS REVIEW UNFAIR LABOR HEALTH & SAFETY COMMERCE ENERGY IMMIGRATION-includes denial of an asylum claim IMMIGRATION-does NOT include denial of an asylum claim TARIFFS OTHER: (SPECIFY) 1. Is any matter relative to this petition or application still pending below? 9 Yes, specify: 9 No 2. To your knowledge, is there any case presently pending or about to be brought before this Court or another court or administrative agency which: (A) Arises from substantially the same case or controversy as this petition or application ? 9 Yes 9 No (B) Involves an issue that is substantially similar or related to an issue in this petition or application ? 9 Yes 9 No If yes, state whether 9 "A," or 9 "B," or 9 both are applicable, and provide in the spaces below the following information on the other action(s): Case Name: Docket No. Citation: Court or Agency: Name of Petitioner or Applicant: Date: Signature of Counsel of Record: NOTICE TO COUNSEL Once you have filed your Petition for Review or Application for Enforcement, you have only 14 days in which to complete the following important steps: 1. 2. Complete this Agency Appeal Pre-Argument Statement (Form C-A); serve it upon your adversary, and file it with the Clerk of the Second Circuit in accordance with LR 25.1. Pay the $500 docketing fee to the Clerk of the Second Circuit, unless you are authorized to prosecute the appeal without payment. PLEASE NOTE: IF YOU DO NOT COMPLY WITH THESE REQUIREMENTS WITHIN 14 CALENDAR DAYS, YOUR PETITION FOR REVIEW OR APPLICATION FOR ENFORCEMENT WILL BE DISMISSED. SEE LOCAL RULE 12.1. Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com