Form Aa 71 PDF Details

Form Aa 71 is a form used to request an exemption from the overtime pay requirement. This form must be completed and submitted by the employer in order to receive approval for the exemption. The purpose of this form is to ensure that all employers comply with federal wage and hour laws. There are several eligibility requirements that must be met in order for an employer to qualify for an exemption from the overtime pay requirement. Completing this form accurately is critical, as any mistakes could result in denied requests and fines. It is important to understand all of the eligibility requirements before attempting to fill out this form. Failing to do so could result in wasted time and money.

QuestionAnswer
Form NameForm Aa 71
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnys department of motor vehicles safety hearing bureau, refundable, Franchised, division of safety and business hearing

Form Preview Example

NewYorkStateDepartmentofMotorVehicles

Franchised Motor Vehicle Dealer

REQUEST FOR ADJUDICATORY PROCEEDING

DivisionofSafetyandBusinessHearings,Room424A Telephone:(518)474-1509 Fax: (518)473-8505

COMPLETE THE INFORMATION REQUESTED BELOW. PLEASE PRINT.

Name:___________________________________________ AKA/DBA_________________________________________

Address(includenumber&Street) ____________________________________________________________________________

City_____________________________ State_____ ZipCode_____________Telephone# ( )

DealerCertificateofRegistrationNo.:_____________________Representedby:____________________________________

Requests a New York State Department of Motor Vehicles Adjudicatory proceeding with:

Franchisor ___________________________________________________________________________________________

Address(includenumber&Street) ___________________________________________________________________________

City_____________________________ State_____ ZipCode_____________Telephone# ( )

Representedby(ifknown):_______________________________________________________________________________

Address(includenumber&Street) ____________________________________________________________________________

City_____________________________ State_____ ZipCode_____________Telephone# (

)

INSTRUCTIONS FOR REQUEST

1)Alldocumentsrelevanttotheclaim(s)madeinthisrequest,includingallcorrespondencebetweenthedealerandfranchisor, mustaccompanythisrequestwhenitisfiledwiththeCommissioner.Includeacopyofthecurrentfranchiseagreementthat existsbetweenthedealerandthefranchisor,andacopyofthecertificateofservice(seeInstruction#2).Submitto:

NYSDepartmentofMotorVehicles

Div.SafetyandBusinessHearings,Room424A 6EmpireStatePlaza

Albany,NY 12228

2)AtthetimethisrequestisfiledwiththeCommissioner,atruecopyofthisrequest,withcopiesofalldocumentsfiledwithit, mustbeserveduponthefranchisorinanymannerspecificallypermittedunderthetermsofthefranchiseagreementor,ifno suchmannerisspecified,thenviacertifiedmail,returnreceiptrequested, addressedtotheofficeroremployeeofthe franchisorfromwhomthedealerhasreceivedcorrespondencerelevanttotheclaimsmadeinthisrequest.

3)This request must be accompanied by a non-refundable filing fee of two thousand dollars ($2,000). Attach a certified checkor moneyorderpayabletotheCommissionerofMotorVehicles.

4)Inashort,plainstatementpresentthefactsthatsupportyourclaimthatthefranchisorhasviolatedoneormorespecificprovisions

ofArticle17-AFranchisedMotorVehicleDealerAct.Also,describeyourrequestforaspecificremedyotherthandamages.

(Useadditionalsheetsasnecessary.)

Your attention is directed to the automatic stay provisions, without bond, under Vehicle and Traffic Law Sections 463(2)(e)(1) and

465(7).

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PleaseSignHere

Date

AA-71(5/14)

How to Edit Form Aa 71 Online for Free

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Writing part 1 in DBA

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