New York State Continuing Legal Education Board 25 Beaver Street, Room 888, New York, NY 10004 • Phone: (212) 428-2105 Fax: (212) 428-2974 • Web site: www.nycourts.gov/attorneys/cle • E-mail: cle@courts.state.ny.us APPLICATION FOR AN EXTENSION OF TIME The CLE Board may grant an extension of time in which to complete the CLE requirement based upon undue hardship or extenuating circumstances. Please note that extensions do not exempt you from the responsibility of filing your Attorney Registration form in a timely manner and paying the required fee. Note: All members of the NYS Bar are presumed to be practicing law in New York. If you do not practice law in New York, you may be exempt from the CLE requirement. If you practiced for part of a CLE reporting cycle, you may have a prorated requirement. (For additional information, visit the CLE Web site.) Check one: Ms. Mr. Name: Street Address: City/State/Zip: Telephone: Fax: E-mail: Attorney Registration #: Date of Birth: Date Admitted to the New York Bar: Have you been practicing law in another jurisdiction for at least five of the last seven years? [ ] Yes [ ] No CLE reporting cycle for which you are seeking an extension: On the next page, please describe the circumstances that prevented you from completing your CLE requirement in a timely manner. Please also list the courses you have taken, the number and categories of credit you have completed and a plan for the completion of your requirement. (Please note that your application will not be processed without this information.) Signature: Date: [ ] Application Returned/Incomplete - You must submit: Application Withdrawn The CLE Board’s determination is as follows: [ ] Denied [ ] Granted [ ] Granted. However, you indicated that throughout the relevant CLE reporting cycle, you: [ ] did not practice law in New York [ ] were retired from the practice of law were a full-time member of the military on active duty Therefore, please visit the CLE Web site for details regarding an exemption from the CLE requirement. If you determine that you are not exempt, then you must complete your CLE requirement by the date below. You must complete your CLE requirement for the CLE reporting cycle indicated above, by the following date: Attorney Registration CLE Update Form enclosed (Once you fulfill your CLE requirement or determine that you are exempt complete the appropriate section and return to the address on the form.) For Office Use Only: Date: This application will be returned to you with the CLE Board’s determination indicated in the box above. You must retain this document with your other CLE records for at least four (4) years. Page 1 of 2 June 2011 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR AN EXTENSION OF TIME In the space below, please describe the circumstances that prevented you from completing your CLE requirement in a timely manner. Also list the courses you have taken, including the number and categories of credit, and explain your plan for completing your CLE requirement. (Please do not submit your certificates of attendance unless specifically requested to do so.) UNDUE HARDSHIP OR EXTENUATING CIRCUMSTANCES THAT PREVENTED YOU FROM COMPLETING YOUR CLE REQUIREMENT IN A TIMELY MANNER: LIST OF CLE COURSES TAKEN, INCLUDING NUMBER AND CATEGORIES OF CLE CREDIT COMPLETED: PLAN FOR COMPLETION OF CLE REQUIREMENT: Page 2 of 2 June 2011 American LegalNet, Inc. www.FormsWorkFlow.com