Fill and Sign the Nuts Ampamp Bolts of Appellate Practice Kentucky Bar Association Form

APPELLANT VS. COURT OF APPEALS DOCKET NO. _______________________________ (leave blank) APPELLEE Appeal From ___________________________ Circuit Court Action No. ___________________________________ Trial Judge: ________________________________ Judgment/Order Appealed From Entered: ___________________ Notice of Appeal Filed: _______________________ Notice of Cross Appeal Filed: _____________________________ 1. Has this case been before an Appellate Court previously? [ ] Yes [ ] No If Yes, provide date and prior case number(s) _____________________________________________________ 2. Type of litigation (type of order; e.g., automobile negligence, breach of contract, domestic, product liability, property dispute, tax, UCC, zoning, etc. ). Attach copy of complaint or other document initiating Circuit Court action. _________________________________________________________________________________________ _________________________________________________________________________________________ 3. Was this case mediated at the trial court level? [ ] Yes [ ] No Internal Use Only AOC-070 Rev. 2-10Page 1 of 2 Commonwealth of Kentucky CR 76.03(3) KENTUCKy COURT OF APPEALS CIvIL APPEAL PREHEARINg STATEmENT l e x e t j u s t i t i a COMMONWEALTHOFKENTUCKY COURTOFJUSTICE Identifying Information Regarding Counsel for APPELLANT: Name of Client _______________________________________________________________________________ ___________________________________________________________________________________________ In the trial court, this party was the [ ] Plaintiff [ ] Defendant [ ] Other (specify) __________________________ Attorney’s Name: _____________________________________________________________________________Address: ____________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Telephone No. _________________________________ Identifying Information Regarding Counsel for APPELLEE: Name of Client _______________________________________________________________________________ ___________________________________________________________________________________________ In the trial court, this party was the [ ] Plaintiff [ ] Defendant [ ] Other (specify) __________________________ Attorney’s Name: _____________________________________________________________________________Address: ____________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Telephone No. _________________________________ Court of Justice AOC-070 Rev. 2-10Page 2 of 24. Circuit Court Disposition (type of order; e.g., Default or Summary Judgment, Dismissal, etc. ). Attach copy of �nal judgment and any separate written opinion by trial court. _________________________________________________________________________________________ _________________________________________________________________________________________ 5. Relief: (a) Damages: Amount Sought $ ____________________ Amount granted $ _______________ (b) Injunction: [ ] Granted [ ] Denied (c) Other:______________________________________________________________________________ _____________________________________________________________________________________ 6. Facts and Issues: (Brief statement of facts, claims, defenses and issues litigated. Attach separate sheet if necessary ). _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 7. Brie�y state issues proposed to be raised on appeal , including jurisdictional challenges, and any question of �rst impression. Attach separate sheet if necessary. _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 8. Will the appeal turn on interpretation or application of a particular case or statute? [ ] Yes [ ] No If Yes, identify case/statute: ___________________________________________________________________ 9. Is there any known case involving substantially the same issue now pending before either appellate court of this state? [ ] Yes [ ] No If Yes, give Case Number: __________________________________________ Case Name: ______________________________________________________________________________ 10. Would a prehearing conference be helpful? [ ] Yes [ ] No Why? ______________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ NOTES: 1) Items 2 and 4 on page 1 require documents to be attached to this Form for proper �ling. 2) Filing of Civil Notice of Appeal suspends running of time for further appeal steps-See CR 76.03(3). CERTIFICATION I/We hereby certify a copy of the foregoing statement was executed and a copy served on: ____________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________ Date: _________________, 2______. ______________________________________________ Signature Print Name : _________________________________________________________________________________ Address : ___________________________________________________________________________________