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Fill and Sign the District Court 497322895 Form

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Rule 1.301, Form No. 11 IN THE DISTRICT COURT OF _____ COUNTY STATE OF OKLAHOMA ___________________, ) Plaintiff, ) ) District Court No. _______. v. ) ) Supreme Court No.________. ____________________, ) Defendant. ) DESIGNATION OF RECORD FOR APPEAL FROM DISTRICT COURT Designation of Record Counter-Designation of Record Amended Designation of Record [Plaintiff or Defendant] _________________ hereby designates the following for inclusion in the record on appeal in this case: A. TRANSCRIPTS 1. Transcripts ordered. (List of transcripts to be included in record, e.g., "Transcript of hearing held June 6, 1994; Transcript of ruling on July 2, 1994; Transcript of Cross- Examination of John Doe at Jury Trial on June 6, 1994; Transcript of Trial on June 6-7, 1994.") 1. 2. 3. 4. 5. ______ 2. I _______________________, attorney for appellant or appellee, party pro se, or petitioner, as indicated below, hereby state that I have not ordered a transcript. 3. Statement by attorney for appellant , counter or cross-appellant, petitioner, or appellant pro se . [Appellees (respondents) need not complete Part (A)(3) of form. See 12 O.S.Supp.1995  990A(G)(1) (b) and (G)(2)]. I, , attorney for appellant (or appellant pro se), hereby state that I have not ordered a transcript because (1) a transcript is not necessary for this appeal, or (2) no stenographic reporting was made. B. EXHIBITS ( E.g., "Plaintiff's Ex. 1, 3, at Jury Trial on June 6, 1994 ; Defendant's Ex. 7, 10 at Jury Trial on June 6, 1994.") 1. 2. 3. 4. C. DESIGNATION OF PLEADINGS AND DOCUMENTS 1. Items are designated by circling the items on a copy of the appearance docket attached hereto. (To use this method of designation a copy of the appearance docket must be attached to the designation of record with the items circled, and all copies of the designation of record filed of record and served on other parties must have a copy of the attached appearance docket showing the items circled.) OR 2. Items are designated by listing the item below with the date it was filed in the trial court. ( E.g., Petition of Plaintiff John Doe - June 6, 1994; First Amended Petition of Plaintiff John Doe - June 13, 1994; Answer of Defendant Sara Doe - June 20, 1994; Jury Instructions - June 27 1994). 1. 2. 3. 4. Additional page(s) may be inserted after this page and continuing with the numbered items designated if necessary. Page must be Titled "Additional Items Designated for Record on Appeal." D. TRANSCRIPT PAYMENT STATEMENT BY COURT REPORTER Part D of this form must be completed by court reporter pursuant to 12 O.S.Supp.1995  990A(G) if the designation is filed by an appellant and a transcript is ordered. Appellee need not complete part D of this form. I, , court reporter for the above styled case, do hereby acknowledge this request for transcript on this ______ day of and have received a deposit in the sum of $_________. E. DATE, SIGNATURE, AND SERVICE BY COUNSEL OR PARTY DATE: _______________, 19 . Signature: __________________________ (Signature of Attorney or Pro Se Party) Attorney for (Appellant or Appellee) OBA No.: _____________________________ Firm: ________________________________ Address: ______________________________ ______________________________________ ______________________________________ Telephone: _____________________________ CERTIFICATE OF SERVICE I, , hereby certify that in addition to filing the original Designation of Record in the district court, a copy of the foregoing Designation of Record was mailed by first class mail, postage prepaid, this ___ day of _________ 20__, to the following: [Names and Addresses of all parties or their counsel of record] _______________________________________

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