Fill and Sign the Notice of Appeal to Circuit Court Municipal Ordinance Violation Form

State of Alabama Unified Judicial System Form MC-16 (front) Rev. 6/07 NOTICE OF APPEAL TO CIRCUIT COURT Municipal Ordinance Violation Case Number STATE OF ALABAMA □ IN THE DISTRICT COURT OF THE MUNICIPALITY OF ______________________ COUNTY ___________________________________ v. ___________________________________ □ IN THE MUNICIPAL COURT OF DEFENDANT _____________________________ , ALABAMA DATE OF JUDGMENT:___________________________________________________________________________ DATE OF DENIAL OF POST-JUDGMENT MOTION:_____________________________________________________ Notice is hereby given that the above-named defendant appeals for trial de novo to the Circuit Court of ___________________________ County, Alabama, from final judgment of conviction in this Court adjudging the defendant to be guilty of the offense of ______________________________________________________ _____________________________________________________________________________________ □ TRIAL WITHOUT JURY □ DEFENDANT DEMANDS TRIAL BY JURY _________________ ___________ ________________ _________________ (Initials of Defendant) (Date) (Initials of Defendant) ( Date) (Note: By checking either one of the boxes above, the defendant acknowledges that he or she was advised of his or her right to a jury trial on appeal. Also, the defendant understa nds that if he or she does not check the “Defendant Demands Trial By Jury” box wit hin seven (7) days of filing this Notice of Appeal, he or she waiv es his or her right to a trial by jury in circuit court.) _____________________________________________ __________________________________________________ _______ Date Signature of Defendant/Attorney ____________________________________________________________________________ _____________________________________ Name of Attorney Attorney’s Business Telephone Number __________________________________________________________________________________________________________ Business Address of Attorney CERTIFICATION OF RECORD ON APPEAL TO CIRCUIT COURT AND COST BILL I, the undersigned Clerk of the above court, do hereby certify that on the ____ day of _ _______________________________ 20____, the defendant, ____________________________________________ _________was convicted in this Court of the offense of______________________________________________________________________ and was sentenced as follows: Fine: $___________; Court Costs: $______________; Re stitution: $____________ for _________________________ _________________________________________, such amounts being due and payable to the court, sentenced to days months in jail, □ other;_________________________________; and that on the _______day of ________________ 20_____, the defendant gave Notice of Appeal to the Circuit Court of _________________________________ County. I do further certify the following documents anne xed hereto are all the records of the proceedings which are in my possession: Original Charging Instrument: □ Copy of Municipal Ordinance, if Applicable □ Appeal Bond/Affidavit of Sureties (See back of form) □ Non-Traffic Citation and Complaint □ Driver History Record □ UTC (#_________________________) □ Case Action Summary/Record of Disposition Signed □ Warrant of Arrest by Judge S howing Judgment and Sentence of Court Other:_______________________________________________________________________________________________ _________________________________________________ _________________________________________________ Date Municipal Co urt Clerk District Court Clerk NOTE: THE ORIGINAL AND COPIES OF THIS NOTICE OF APPEAL MUST BE STAMPED IMMEDIATELY UPON RECEIPT. Filed in this office on this ___________ day of ____________________, 20_________ ORIGINAL: Circuit Court COPY: Lower Court COPY: Defendant Case Number NOTICE OF APPEAL TO CIRCUIT COURT Municipal Ordinance Violation MC-16(back) Rev. 6/07 APPEAL BOND I, (Defendant), as principal, and I (we) (please print) ________________________________________________________________ pay the Municipality of ___________________________________________ , Alabama, the sum of $_______________ time thereafter until discharged by law to answer this charge of _________________________________________ SURETY NUMBER 1 – Property** _______________________________________________________________________________________ Exemptions and Liabilities** ______________________________________________________________________________________________________________ Other Outstanding Surety Bonds: Num ber __________________________________A ggregate Amount: $ ______________________________ SURETY NUMBER 2. - Property** Exemptions and Liabilities** Other Outstanding Surety Bonds: Number Aggregate Amount: $ □ APPROVED □ WAIVED this the Title Signature ,20 day o f * Does not apply: Immediate Family Member. Specify Relationship **Attach a separate sheet if necessary Business Telephone Number Zip Code State City Surety's Business Address Signature of Surety Social Security Number Surety's Name (Print) (L.S.) * Does not apply: Immediate Fami ly Member. Specify Relationship * *Attach a separate sheet if necessary Business Telephone Number Zip Code State City Surety's Business Address Signature of Surety Social Security Number Surety's Name (Print) (L.S.) In addition to the statements made above, _____________________________________________________, the undersigned Surety(ies), hereby certify [that I (we) am/are not [an] attorney(s), [a] judicial official(s), or [a] person(s) authorized to take bail and]* that I(we) own property in this state that has a fair market value equal to or greater than the amount of the appeal bond in this cause, exclusive of property exempt from execution and above and over all liabilities, including the amount of all other outstanding appeal bonds entered into by me (us). [If the surety's(ies') property is valued at less than the amount of the bond and is to be aggregated with the property of other sureties, state the value of the surety's(ies') property exclusive of liabilities and exemptions]. AFFIDAVIT OF SURETY(IES) Home or Business Telephone Number Zip Code State Cl ty Home or Business Address Signature of Defendant Date (L.S.) It is further agreed and understood that this is a continui ng bond which shall remain in full force and effect until such time as the undersigned are duly exonerated. Signed and sealed this date with notice that false statements are punishable as perjury. We hereby severally certify that we have property valued over and above all debts and liabilities that have a fair market value equal to or greater than the amount of the above bond and we, and each of us, waive the benefits of all laws exempting property from levy and sale under execution or other process for the collection of debt by the Constitution and laws of the State of Alabama, and we especially waive our rights to claim exempt our wages or salary, that we have under the laws of Alabama and our rights to homestead exemptions that we have under the Constitution of Alabama and the laws of the State of Alabama, as set out in a separate writing. , or any other charge as authorized by law. (not to exceed $1,000 or twice the amount of fine and costs) and all costs incurred in this Court and on appeal in this Court unless the above-named Defendant appears before the circuit court on the scheduled date and from time to , as surety(ies), agree to Bond