22 NYCRR 671.5

If a defendant shall have appeared pro se in the trial court, then, upon imposing sentence or upon the denial of a motion made pursuant to C PL 440.10 or 440.20 or the denial or dismissal of the habeas corpus or CPLR article 78 application or proceeding, the trial court shall concurrently advise the defendant of his right to appeal or to make application for permission to appeal or for a certificate granting leave to appeal, as the case may be. The court shall also concurrently advise the defendant of his additional right, upon proof of his financial inability to retain counsel and to pay the cost and expenses of the appeal, to apply to the appellate court for the assignment of counsel and for leave to prosecute the appeal as a poor person and to dispense with printing; and that where permission to appeal or a certificate granting leave to appeal is required, such application for poor person relief will be entertained only if, as and when such permission or certificate is granted. If in open court the defendant orally so requests or if thereafter he so requests in writing and such written request be timely received by the clerk of the trial court, said clerk shall forthwith prepare and serve and file an appropriate notice of appeal on defendant's behalf, or, if a certificate granting leave to appeal is required, serve and file the application therefor in accordance with the rule hereinabove provided with respect to such application. As a part of every such application the clerk shall annex and transmit the original record of the proceedings to the appellate court. Upon the determination of the application, the original record of the proceedings shall be returned to the trial court together with a certified copy of the order entered upon the application. A certified copy of such order shall also be sent to the defendant at his address shown in the application.