AEU2: Certificate of Correction
VIOLATION INFORMATION
SUMMONS NUMBER
(required for certification of Department of Buildings
OATH/ECB Summons or Violation)
1
A F F I D A V I T
(Street Address) (Borough and Zip)
Place of occurrence
State of
County of
Respondent named on the violation (if named respondent is an individual)
Officer or Director of the named respondent Corporation (circle one)
Managing Agent of the named respondent (attach a notarized Letter of Designation by respondent)
Owner of Property but not named respondent (if you are a new Owner, attach copy of deed)
Managing Agent of place of occurrence (attach a notarized Letter of Designation by Owner)
Partner of named respondent partnership
Contractor or other Agent of named respondent (attach a notarized written authorization from respondent)
I, , duly swear under penalty of perjury that I am the (check one):
(Street Address) (City, State, Zip)
My mailing address is
(Street Address) (City, State, Zip)
Please mail results to
PERSON WHO PERFORMED WORK
2
I have complied with the order of the Commissioner to correct each condition cited on this violation. The work described in the attached statement was
completed on and was performed by (check one):
(Date)
Myself
Contractor
Architect/Engineer
NAME (person who performed work)
COMPANY
ADDRESS
LICENSE/REGISTRATION #/LICENSEE/CONTRACTOR
My Employee
REQUIRED: I have attached a sworn/affirmed statement describing the work done to correct the violating condition(s). In addition, I have
attached copies of all permits, bills, receipts, photographs, and/or other documentary proof the violating condition(s) has/have been corrected, or have
explained in my statement why such are not available. I am aware I may be required to attend any pending hearing on summons or violation or risk
imposition of default penalties.
CURE SUBMISSION (check box below ONLY if eligible and you are requesting a CURE - see reverse)
3
CURE REQUEST. I admit the existence of the violation(s) charged. I am aware a hearing is required if my request is not accepted.
STATEMENT OF SIGNATURE
4
NAME (print)
Notarization State of New York, County of:
NOTARY SEAL
SIGNATURE
Sworn to or affirmed under penalty of perjury
day of 20
DATE NOTARY SIGNATURE
I have personal knowledge the violating condition(s) have been corrected as per this affidavit and statement(s) attached.
False certification is a criminal misdemeanor under sections 28-203.1.1 and 28-211.1 of the NYC Administrative Code, punishable by up to one (1) year imprisonment
and/or fine of up to $25,000. It is also punishable with a civil penalty of up to $25,000.
Rev. 3/19
Mail or return this form in-person, with supporting documents to:
NYC Department of Buildings - Administrative Enforcement Unit
280 Broadway, 1st Floor, New York, NY 10007; Phone: (212) 393-2405
