Fill and Sign the Notice Appeal Form 497307007

Form App. R. 9-1 Notice of Appeal STATE OF INDIANA ) IN THE [insert name of trial court] ) SS: COUNTY OF _________ ) CASE NO. [insert trial court number] ___________________________, ) ) Plaintiff(s), ) ) vs. ) ) ___________________________, ) ) Defendant(s). ) NOTICE OF APPEAL FROM TRIAL COURT [Plaintiff or Defendant - Insert designation and name of the party appealing], [by counsel or pro se - select one], pursuant to Ind. Appellate Rule 9(A), respectfully gives notice of an appeal from the following judgment(s) or order(s) entered by the [insert the name of the court]: [list title(s) and date(s) of appealed judgment(s) or order(s).] This appeal is from [a final judgment or an interlocutory order – select one.] This appeal will be taken to the Indiana [Supreme Court or Court of Appeals - select one pursuant to Ind. Appellate Rules 4&5]. Pursuant to Ind. Appellate Rule 10, the clerk of [insert name of trial court] is requested to assemble the Clerk’s Record, as defined in Ind. Appellate Rule 2(E). Pursuant to Ind. Appellate Rule 11, the court reporter of the [insert name of the court] is requested to transcribe, certify, and file with the clerk of the [insert name of trial court] the following hearings of record, including exhibits: [designate requested portions of the transcript] Respectfully submitted , _______________________________________ [Insert Name of Attorney or pro se party] Address Telephone number CERTIFICATE OF SERVICE The undersigned hereby certifies that a copy of the foregoing has been served upon the following by [indicate method of service], this ____ day of __________, 20__: [insert list of parties served, see Ind. Appellate Rule 9(A)(1) ] ________________________________________ [Insert name of Attorney or pro se party] 2