N.Y. Comp. Codes R. & Regs. tit. 12, § 69.3
Content of petition.
Department of Labor
- (a) The petition shall state what dispensation is desired, what action was taken before and by the Commissioner of Labor, and the facts which the appellant claims to justify the dispensation.
(b) No special form is required. The following form is a suggestion:
STATE OF NEW YORK
INDUSTRIAL BOARD OF APPEALS
_____________X
Defense Emergency Act Appeal
by Petition
(Insert name of Appellant)
_____________X
1. Appellant is (a resident of , residing at) (a New York corporation
with offices at) (insert address) engaged in
(state nature of business)
at (insert plant address) .
___________________.
- 2. The following dispensation is desired:
3. Application therefor was made on (insert date) to the Commissioner
of Labor, who has taken the following action:
4. The facts justifiying the dispensation are:
(Type name of Appellant)
(Signature of Appellant or authorized representative)