Fill and Sign the Filing the Notice of Appealeleventh Circuitunited States Form

From: Trial Docket No: v. NORTH CAROLINA COURT OF APPEALSAPPEAL INFORMATION STATEMENT (County/Agency) COA Docket No: Trial Judge: Party(ies) filing appeal: Date judgment was entered: Date of Notice of Appeal: Is this a final judgment as to all claims and all parti es? a) Yes No b) If no, state the basis on which the judgment/order is immediately appeal\ able. Check the appropriate line(s) best describing the nature of the case: Alimony Attorneys’ fees Child custody/support Construction law Contempt Contract law Corporate law Criminal law, DWI Criminal law, habitual felon Criminal law, probation revocation Criminal law, otherSpecify: Debtor/creditor rights Negligence Paternity Check the appropriate line(s) to show the ruling being appealed: Administrative ruling Declaratory judgment Directed verdict Other (specify) : Products liability Other (specify) : Driver’s license revocation Education law Employment and Labor Environmental law Equitable distribution Health care Insurance, auto Insurance, other Intentional torts Juvenile, delinquent Juvenile, other Landlord/tenant Workers’ compensation Wrongful discharge Professional malpractice Real property rights Sanctions Slip and fall Taxation Termination of parental rights Tort Claims Act Unemployment compensation Unfair and deceptive practices Utilities Wills, trusts, estates Wrongful death Zoning/annexation Injunction Judgment (bench trial) Judgment (guilty plea) Judgment (jury verdict) Judgment notwithstanding the verdict Judgment (probation revocation) Summary judgment COA - 81, Rev. 10/12 © 2012 Administrative Office of the Courts State issues to be raised on the appeal (attach one additional page, if necessary) : a) 1. 2. 3. 4. 5. b) Dismissal Has any prior appeal in this case been filed in either appellate court? a) If “Yes”, provide appellate court docket number(s): b) Are any other appeals in this case pending before either state appellate\ court? If “Yes”, provide appellate court docket number(s): c) To your knowledge, are there any other appeals raising substantially rel\ ated issues pending before eitherappellate court? 6. If “Yes”, provide case name(s) and docket number(s), if known, and explain the manner in which the appeals are related: Are there essential questions raised by this appeal that cannot be adequately presented by the written briefs alone a) and therefore require oral arguments? b) Has this appeal, or the matters with which the appeal is concerned, been\ settled or rendered moot? 7. Do you request oral arguments on this appeal? Yes No Yes No Yes No Yes No Yes No Yes No 8. If “Yes”, please explain: If “No”, the undersigned hereby certifies that he/she will promptl\ y notify the Court of Appeals if the appeal is hereafter settled or rendered moot. (please initial) . Is there any reason why this appeal should be expedited? 9. Yes No If “Yes”, please explain: Has the execution or enforcement of the order, judgment or other determi\ nation from which the appeal has been taken been stayed pending disposition of the appeal? 10. Yes No The undersigned attorney for the appellant(s), or the Pro Se appellant\ , hereby certifies that the information provided herein is true to the best of his/her own knowledge. Signed this the day of20. Signature (Type name(s), address and telephone number under signature.) (Attach certificate of service.) ******************************************************** Instructions 1. These instructions govern the preparation and filing of the APPEAL INFORMATION STATEMENT adopted by the North Carolina Court of Appeals and required by Rule 41 of the North Carolina Rules of Appellate Procedure. 2. An APPEAL INFORMATION STATEMENT shall be completed and filed by the appe\ llant(s) for each record on appeal filed with the Court of Appeals. 3. The Clerk of the Court of Appeals shall provide a copy of the APPEAL INFORMATION STATEMENT form to counsel or parties of record once the record on appeal has been docketed with the Court of Appeals. 4. Responses to inquiries on the APPEAL INFORMATION STATEMENT shall be typed, unless the form indicates otherwise. 5. In all appeals filed with the Court of Appeals, the appealing party or parties shall file the completed APPEAL INFORMATION STATEMENT with the Clerk of the North Carolina Court of Appeals, P.O. Box 2779, Raleigh, NC 27602-2779, at or before the time the appellant’s brief is filed, with service upon all other parties. 6. The APPEAL INFORMATION STATEMENT is not a b rief and should not contain argument or motions. The issues should be expressed thoroughly but without unnecessary detail. Counsel or pro se parties should make every effort to include in the APPEAL INFORMATION STATEMENT all of the iss ues that will be presented to the court. 7. The Court of Appeals may impose sanctions on counsel or pro se parties who fail to complete and file this form. COA - 81, Side Two, Rev. 10/12 © 2012 Administrative Office of the Courts