FORM CPL-11-97 STATE OF NEWYORK A PPELLA DIV IO TE IS N SUPREM COU E RT THIRD DEPARTMENT ----------------------------------------------------------------------THE PEOPLE OF THE STATE OF NEW YORK : : v : : Defendant. : ----------------------------------------------------------------------- Application for Leave to Appeal Pursuant to CPL 460.15 Please take notice that, pursuant to CPL 460.15, application will be made to a Justice of the Supreme C ourt, Appellate Division, Third Departm ent, at the next m otion day of said court more than 13 days after service hereof, at the Justice Building in the City of Albany, New York, for an order granting leave to appeal from the order of the County Court, ____________________ County, which denied a post-conviction motion. AFFIDAVIT IN SUPPORT OF MOTION STATE OF NEWYORK CO UNTY O _____________________ ss.: F ___________________________________, being duly sworn, deposes and says: 1. I seek leave to appeal from an order of the County Court of ____________ County, dated _____________________, which denied my application for postconviction relief. Attached are copies of: A. My application to County Court for post-conviction relief, dated _________. B. Affidavit or affirmation of _____________________________, District Attorney/ Assistant District Attorney of ________________ County, dated __________, in opposition. C. Decision of Judge __________________________, _______________, which denied my application. D. Order dated _______________________________. 1 dated 1 County Court may have issued a decision on your application for post-conviction relief and, thereafter, entered an order on that decision. If so, attach copies of both documents. If, however, County Court denied your application in a combined decision-order, attach only a copy of that document. 2002 © American LegalNet, Inc. 2. The denial of my post-conviction application was error for the following reasons: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 3. The contentions that I will raise on this appeal, if leave to appeal is granted, have not previously been presented and passed upon by this or any other appellate court. 4. A copy of this application is being sent by mail to the District Attorney of _______________________ County this _____ day of ________________, _____. ___________________________________ (Signature) Print Name:_________________________ Address: __________________________ __________________________ __________________________ Sw to before m this _____ day orn e of ______________________, ______. _________________________________ N otary Pub lic 2002 © American LegalNet, Inc.