PO Box 2074 Empire State Plaza Agency Building 2, 20 th Floor Albany, New York 12220 - 2074 Phone: (518) 457 - 2578 I Fax: (518) 457 - 2664 www.perb.ny.gov Consent to Electronic Service Case numbers : Charging p arty: Respondent(s): I, (enter your name) , am (check one) the representative of a party in the above - captioned action or a self - represented party in this matter. I hereby consent to receive service of Exceptions and supporting brief at th is email address : Signature: Date: Print name: Party Represented: Email this completed form with Exceptions to boardsecretary@perb.ny.gov . (Form number/date updated PERB101 (2/19)) American LegalNet, Inc. www.FormsWorkFlow.com