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Rules of the Supreme Court

APPENDIX C — CAPTION AND CERTIFICATION FORMS

  • C-1Instructions
  • C-2Standard cover
  • C-3Caption forms
  • C-4Simple Notice of Criminal Appeal
  • C-5Civil or Administrative Notice of Appeal
  • C-6Petition for Review checklist
  • C-7Attorney and self-represented signature blocks
  • C-8Factual declaration
  • C-9Combined filing certifications
  • C-10Proof of original or alternative service
  • C-11Petition for Rehearing certificate
  • C-12Technical-failure notice
  • C-13Fee-waiver request
  • C-14Request for appointed counsel
  • C-15Adoption-order certificate

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]
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