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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-9. Combined filing certifications

Cite asRid. R. Sup. Ct. app. C-9Official text at page 49

The following may be combined after the signature block:

WORD-COUNT CERTIFICATE
I certify that this filing contains [NUMBER] words counted by
[SOFTWARE], excluding the material excluded by Rule 38(b).
[For a self-represented page alternative: This filing uses the Rule 38
page alternative and contains [NUMBER] substantive pages.]
PRIVACY AND ACCESS CERTIFICATE
I certify that I reviewed this filing for protected information under
Rules 33 and 34. This is the [PUBLIC / REDACTED] version. [No secure
material is included / Secure material was lodged by the method ordered
on DATE].
CITATION AND RECORD CERTIFICATE
I certify that I verified each material quotation, legal citation,
record reference, username, immutable identifier, and link against the
source identified in the filing.
SERVICE STATEMENT
Choose each applicable statement:
[ ] Rule 30 electronic service on acceptance is sufficient.
[ ] Concurrent Rule 31 service was required and was completed as shown
in the attached or separately filed proof.
[ ] The following participant could not be served after diligent effort:
[IDENTITY, SAFE DESCRIPTION OF EFFORTS, AND RELIEF REQUESTED].
[ ] Service is governed by the confidential-service order entered on
[DATE].
/s/ [SIGNER]
Date and UTC time: [________]
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