This government document is issued by The Second Circuit Court of Appeals / Thurgood Marshall U.S. Courthouse for use in New York
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https://www.ca2.uscourts.gov/clerk/case_filing/appealing_a_case/pdf/Appendix%20A%20to%20How%20to%20File%20an%20Anders%20Brief%20in%20a%20Criminal%20Case%20(Anders%20checklist).pdf