Contains Fields to Complete on-line (print out for filing) 
A form for pro se litigants (Rev. 12/13) 

In civil and miscellaneous cases Filing Users must electronically file any Notice of Appeal through the ECF system. The fee is paid on-line through the ECF system. Instructions and training are available at ttps://www.nysd.uscourts.gov/electronic-case-filing.

Pro se litigants who are not Filing Users are exempt from that portion of this Rule that requires litigants to electronically file the Notice of Appeal. The Clerk’s Office will scan and electronically file all proper appellate papers received from pro se litigants who are not Filing Users.

Form Instructions