APPENDIX C — CAPTION AND CERTIFICATION FORMS
Section C-5. Civil or Administrative Notice of Appeal
Cite asRid. R. Sup. Ct. app. C-5Official text at page 48
NOTICE OF [CIVIL / ADMINISTRATIVE] APPEAL 1. Appellant: [FULL ACCOUNT IDENTITY] 2. Appellee: [FULL ACCOUNT IDENTITY] 3. Lower tribunal and case number: [________] 4. Judgment or order appealed: [________] 5. Date and UTC time of entry: [________] 6. Statute granting an appeal as of right: [CITATION] 7. Concise expected issues: [________] 8. Essential record categories: [________] 9. Pending post-judgment motion: [YES—IDENTIFY / NO] 10. Related appeal: [________ / NONE] 11. For an Administrative Court appeal only: a. Statutory ground under Rule 45(b): [________] b. Exact challenged ruling: [________] c. Record location preserving the ground: [________] I appeal the identified judgment or order. [SIGNATURE BLOCK] [SERVICE STATEMENT]