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LIC51: VOLUNTARY AUTHORIZATION (City of New York)

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LIC51 Rev. 09/17
LIC51: VOLUNTARY AUTHORIZATION
FOR SERVICE OF PROCESS by EMAIL
Form must be typewritten
LICENSEE INFORMATION
1) Last Name
2) First Name
3) Middle Initial
4) License Type
5) License Number
6) Associated Business Name
7) Title at Business
I hereby affirm that I am authorized to make decisions on behalf of the above named corporation,
partnership, or other corporate entity.
I hereby voluntarily agree to accept service of Notices of Violation (NOV)/Summonses issued by
the New York City Department of Buildings (DOB) by the email address listed above. I agree that
email service of the NOV shall be deemed valid service of the NOVs/Summonses under New York
City Charter 1049-a, section 6-08 of the rules of OATH Hearings Division and other applicable laws
to allow for the docketing of judgments. I further agree not to raise any defect with respect to
service for any NOVs/Summonses received from DOB at the email address above, in any forum,
including before a hearing officer of OATH/ECB, the Environmental Control Board itself, or in any
court of law.
I may withdraw this Voluntary Authorization for Service of Process by Email at any time upon
thirty (30) days written notice to licensingdob@buildings.nyc.gov.
NAME (print)
NOTARIZATION
State of New York, County of:
NOTARY SEAL
SIGNATURE
Sworn to (or affirmed) before me
under penalty of perjury this
______ day of ________________
20 ______.
DATE
NOTARY SIGNATURE
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LIC51: VOLUNTARY AUTHORIZATION (City of New York)

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Completed 7 November 2020

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