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Form 1. Notice of Appeal Tax, Civil, Family Court - (Except Juvenile Cases), and Probate SUPERIOR COURT OF THE DISTRICT OF COLUMBIA NOTICE OF APPEAL (______CROSS APPEAL) TAX, CIVIL, FAMILY COURT - (EXCEPT JUVENILE CASES), AND PROBATE Superior Court Case Caption: ____________________________________________________ Superior Court Case No.: _______________________________________________________ A. Notice is given that (person appealing) __________________________________ is appealing an order/judgment from the:
Tax Division
Civil Division
Family Court
Probate Division 1. Date of entry of judgment or order appealed from (if more than one judgment or order appealed, list all): _______________________________________________________________________ 2. Filing date of any post-judgment motion: ______________________________________ 3. Date of entry of post-judgment order:_________________________________________ 4. Superior Court Judge: _____________________________________________________ 5. Is the order final (i.e., disposes of all claims and has been entered by a Superior Court Judge, not a Magistrate Judge)?
YES
NO If no, state the basis for jurisdiction: ______________________________________ Has there been any other notice of appeal filed in this case:
YES
NO If so, list the other appeal numbers: _______________________________________ 6. If this case was consolidated with another case in this court, list the parties’ names and the Superior Court case number: _____________________________________________ B.Type of Case:
Civil I
Civil II
Landlord and Tenant
Neglect
Termination of Parental Rights
Adoption
Guardianship
Mental Health
Probate
Intervention
Domestic Relations
Mental Retardation
Paternity & Child Support
Other: ____________________________________ C.Indicate Status of Case:
Paid
In Forma Pauperis
CCAN Was counsel appointed in the trial court?
YES
NO (COMPLETE REVERSE SIDE) Revised 11/09 D.Provide the names, addresses, and telephone numbers of all parties to be served. For persons represented by counsel, identify counsel and whom the counsel represents. For each person, state whether the person was a plaintiff or defendant in the Superior Court. *Attach additional pages if necessary. Name Address Party Status Telephone No. (Plaintiff, Defendant) ______________ ______________ ___________________ _______________ ______________ ______________ ___________________ _______________ ______________ ______________ ___________________ _______________ E. Identify the portions of the transcript needed for appeal, including the date of the proceeding, the name of the Court Reporter (or state that the matter was recorded on tape if no Court Reporter was present), the courtroom number where the proceeding was held, and the date the transcript was ordered, or a motion was filed for preparation of the transcript. *Attach additional pages if needed. Date of Proceeding/Portion Reporter/Courtroom No. Date ordered ____________________________ _______________________ ______________ ____________________________ _______________________ ______________ ____________________________ _______________________ ______________ ____________________________ _______________________ ______________
Check this box if no transcript is needed for this appeal. F. Person filing appeal:
Plaintiff Pro Se
Defendant Pro Se
Third Party/Intervenor
Counsel for Plaintiff
Counsel for Defendant ATTACH A COPY OF THE ORDER, JUDGMENT OR DOCKET ENTRY FROM WHICH THIS APPEAL IS TAKEN _________________________________ ____________________________ ________ Print Name of Appellant/Attorney Signature Bar No. _________________________________ ___________________________________ Address Telephone Number *Appellant is responsible for ordering and paying the fee for transcript(s) in the Court Reporting and Recording Division, Room 5500. If appellant has been granted In Forma Pauperis status, or had an attorney appointed by the Family Court, and transcript is needed for this appeal, appellant must file a Motion for Transcript in Court Reporting and Recording Division, Room 5500. That office number is (202) 879-1009. If that motion is granted, transcript will be prepared at no cost to appellant.