Notice Designating Record on Appeal (Limited Civil Case) APP-103 Clerk stamps date here when form is filed. Instructions • This form is only for choosing (“designating”) the record on appeal in a limited civil case. • Before you fill out this form, read Information on Appeal Procedures for Limited Civil Cases (form APP-101-INFO) to know your rights and responsibilities. You can get form APP-101-INFO at any courthouse or county law library or online at www.courtinfo.ca.gov/forms. • This form can be attached to your notice of appeal. If it is not attached to your notice of appeal, you must serve and file this form within 10 days after you file your notice of appeal. If you do not file this form on time, the court may dismiss your appeal. You fill in the name and street address of the court that issued the judgment or order you are appealing: Superior Court of California, County of • Fill out this form and make a copy of the completed form for your records and for each of the other parties. • Serve a copy of the completed form on each of the other parties and keep proof of this service. You can get information about how to serve court papers and proof of service from What Is Proof of Service? (form APP-109-INFO) and on the California Courts Online Self-Help Center site at www.courtinfo.ca.gov/selfhelp/lowcost/getready.htm#serving. • Take or mail the original completed form and proof of service on the other You fill in the number and name of the trial court case in which you are appealing the judgment or order: Trial Court Case Number: Trial Court Case Name: parties to the clerk’s office for the same court that issued the judgment or order you are appealing. It is a good idea to take or mail an extra copy to the clerk and ask the clerk to stamp it to show that the original has been filed. You fill in the appellate division case number (if you know it): Appellate Division Case Number: 1 Your Information a. Name of appellant (the party who is filing this appeal): b. Appellant’s contact information (skip this if the appellant has a lawyer for this appeal): Street address: Street Mailing address (if different): Phone: ( City Street ) State City Zip State Zip E-mail (optional): c. Appellant’s lawyer (skip this if the appellant does not have a lawyer for this appeal): State Bar number: Name: Street address: Street City State Zip Mailing address (if different): Street Phone: ( ) Fax (optional): ( Judicial Council of California, www.courtinfo.ca.gov Revised July 1, 2009, Optional Form Cal. Rules of Court, rule 8.831 City State Zip E-mail (optional): ) Notice Designating Record on Appeal APP-103, Page 1 of 6 5 (Limited Civil Case) American LegalNet, Inc. www.FormsWorkflow.com Trial Court Case Number: Trial Court Case Name: Information About Your Appeal 2 On (fill in the date): trial court case identified in the box on page 1 of this form. I/my client filed a notice of appeal in the Record of the Documents Filed in the Trial Court 3 I elect (choose)/My client elects to use the following record of the documents filed in the trial court (check a or b and fill in any required information): a. Clerk’s Transcript. (Fill out (1)–(4).) Note that, if the court has adopted a local rule permitting this, the clerk may prepare and send the original court file to the appellate division instead of a clerk’s transcript. (1) Required documents. The clerk will automatically include the following items in the clerk’s transcript but you must provide the date each document was filed: Document Title and Description Date of Filing (1) Notice of appeal (2) Notice designating record on appeal (this document) (3) Judgment or order appealed from (4) Notice of entry of judgment (if any) (5) Notice of intention to move for new trial or motion to vacate the judgment, for judgment notwithstanding the verdict, or for reconsideration of an appealed order (if any) (6) Ruling on any item included under 5 (7) Register of actions or docket (8) Any transcript furnished to the jury or tendered to the court under rule 2.1040. (2) Additional documents. If you want any documents in addition to the required documents listed above to be included in the clerk’s transcript, you must identify those documents here. I would like the clerk to include in the transcript the following documents that were filed in the trial court. (Identify each document you want included by its title and provide the date it was filed, if you know it.) Document Title and Description Date of Filing (1) (2) (3) (4) (5) Check here if you need more space to list other documents and attach a separate page or pages listing those documents. At the top of each page, write “APP-103, item 3a(2).” Revised July 1, 2009 Notice Designating Record on Appeal (Limited Civil Case) APP-103, Page 2 of 6 Trial Court Case Number: Trial Court Case Name: 3 a. (continued) (3) Exhibits. I would like the clerk to include in the transcript the following exhibits that were admitted in evidence, refused, or lodged in the trial court. (For each exhibit, give the exhibit number (such as Plaintiff’s #1 or Defendant’s A) and a brief description of the exhibit and indicate whether or not the court admitted the exhibit into evidence. If the trial court has returned a designated exhibit to a party, the party who has that exhibit must deliver it to the trial court clerk as soon as possible.) Exhibit Number Description Admitted Into Evidence Yes No Yes No Yes No Yes No Yes No Check here if you need more space to list other exhibits and attach a separate page or pages listing those exhibits. At the top of each page, write “APP-103, item 3a(3).” (4) Payment for clerk’s transcript. (Check a or b.) (a) I will pay the trial court clerk for this transcript myself when I receive the clerk’s estimate of the costs of the transcript. I understand that if I do not pay for the transcript, it will not be prepared and provided to the appellate division. (b) I am asking that the clerk’s transcript be provided at no cost to me because I cannot afford to pay this cost. I have attached (check (i) or (ii) and attach the checked document): (i) An order granting a waiver of the cost under rules 3.50–3.58 (ii) An application for a waiver of court fees and costs under rules 3.50–3.58 (use Request to Waive Court Fees (form FW-001)) OR b. Agreed statement. (You must complete item 5 d below and attach to your agreed statement copies of all the documents that are required to be included in the clerk’s transcript. These documents are listed in 3a(1) above and in rule 8.832 of the California Rules of Court.) Record of Oral Proceedings in the Trial Court You do not have to provide the appellate division with a record of what was said in the trial court (this is called a record of the “oral proceedings”). But, if you do not, the appellate division will not be able to consider what was said during the trial court proceedings in deciding whether a legal error was made in those proceedings. 4 I elect (choose)/My client elects to proceed (check a or b): a. WITHOUT a record of the oral proceedings in the trial court (skip 5 ; sign and date this form). I understand that if I elect to proceed without a record of the oral proceedings in the trial court the appellate division will not be able to consider what was said during those proceedings in determining whether a legal error was made. (Write initials here): Revised July 1, 2009 Notice Designating Record on Appeal (Limited Civil Case) APP-103, Page 3 of 6 Trial Court Case Number: Trial Court Case Name: 4 (continued) b. 5 WITH a record of the oral proceedings in the trial court (complete item 5 below). I understand that, if I elect (choose) to proceed WITH a record of the oral proceedings in the trial court, I have to choose the record I want to use and take the actions described below to make sure that this record is provided to the appellate division. I understand that if I do not take the actions described below and the appellate division does not receive this record, I am not likely to succeed in my appeal. (Write initials here): I want to use the following record of what was said in the trial court proceedings in my case (check and complete only one of the following below—a, b, c, d, or e): a. Reporter’s Transcript. This option is available only if there was a court reporter in the trial court who made a record of what was said in court. Check with the trial court to see if there was a court reporter in your case before choosing this option. (Complete (1) and (2)): (1) Designation of proceedings to be included in reporter’s transcript. I would like the following proceedings in the trial court to be included in the reporter’s transcript. (You must identify each proceeding you want included by its date, the department in which it took place, a description of the proceedings [for example the examination of jurors, motions before trial, the taking of testimony, or the giving of jury instructions], and, if you know it, the name of the court reporter who recorded the proceedings.) Date Department Court Reporter’s Name Description (1) (2) (3) (4) (5) (6) (7) Check here if you need more space to list other proceedings and attach a separate page or pages listing those proceedings. At the top of each page, write “APP-103, item 5a.” (2) Payment for reporter’s transcript. I will pay the trial court clerk’s office for this transcript myself when I receive the court reporter’s estimate of the costs of this transcript. I understand that if I do not pay for this transcript, it will not be prepared and provided to the appellate division. (Write initials here): OR Revised July 1, 2009 Notice Designating Record on Appeal (Limited Civil Case) APP-103, Page 4 of 6 Trial Court Case Number: Trial Court Case Name: 5 (continued) b. Transcript From Official Electronic Recording. This option is available only if an official electronic recording was made of what was said in the trial court. Check with the trial court to see if an official electronic recording was made in your case before choosing this option. (Check and complete (1) or (2)): (1) I will pay the trial court clerk for this transcript myself when I receive the clerk’s estimate of the costs of the transcript. I understand that if I do not pay for the transcript, it will not be prepared and provided to the appellate division. (2) I am asking that the transcript be provided at no cost to me because I cannot afford to pay this cost. I have attached (check (a) or (b) and attach the appropriate document): (a) An order granting a waiver of the cost under rules 3.50–3.58 (b) An application for a waiver of court fees and costs under rules 3.50–3.58 (use Request to Waive Court Fees (form FW-001). The court will review this form to decide if you are eligible for a fee waiver). OR Copy of Official Electronic Recording. This option is available only if an official electronic recording was made of what was said in the trial court, the court has a local rule for the appellate division authorizing parties to use the official electronic recording itself as the record of the court proceedings, and all of the parties have agreed (stipulated) that they want to use the recording itself as the record of what was said in the case. Check with the trial court to see if an official electronic recording was made in your case before choosing this option. You must attach a copy of your agreement (stipulation) with the other parties to this notice. (Check and complete (1) or (2)): c. (1) I will pay the trial court clerk for this copy of the recording myself when I receive the clerk’s estimate of the costs of this copy. I understand that if I do not pay for this copy of the recording, it will not be prepared and provided to the appellate division. (2) I am asking that a copy of the recording be provided at no cost to me because I cannot afford to pay this cost. I have attached (check (a) or (b) and attach the appropriate document): (a) An order granting a waiver of the cost under rules 3.50–3.58 (b) An application for a waiver of court fees and costs under rules 3.50–3.58 (use Request to Waive Court Fees (form FW-001). The court will review this form to decide if you are eligible for a fee waiver). OR d. Agreed Statement. I want to use an agreed statement (a summary of the trial court proceedings agreed to by the parties) as the record of what was said in my case. (Check (1) or (2)): (1) I have attached an agreed statement to this notice. (2) All the parties have agreed in writing (stipulated) to try to agree on a statement (you must attach a copy of this agreement (stipulation) to this notice). I understand that, within 30 days after I file this notice, I must file either the agreed statement or a notice indicating the parties were unable to agree on a statement and a new notice designating the record on appeal. Revised July 1, 2009 Notice Designating Record on Appeal (Limited Civil Case) APP-103, Page 5 of 6 Trial Court Case Number: Trial Court Case Name: 5 (continued) OR e. Statement on Appeal. I want to use a statement on appeal (a summary of the trial court proceedings approved by the trial court) as the record of what was said in my case. (Check (1) or (2)): (1) I have attached my proposed statement on appeal to this notice of appeal. (If you are not represented by a lawyer in this appeal, you must use Proposed Statement on Appeal (Limited Civil Case) (form APP-104) to prepare and file this proposed statement. You can get a copy of form APP-104 at any courthouse or county law library or online at www.courtinfo.ca.gov/forms.) (2) I have NOT attached my proposed statement. I understand that I must serve and file this proposed statement in the trial court within 20 days of the date I file this notice and that if I do not file the proposed statement on time, the court may dismiss my appeal. Date: Type or print your name Revised July 1, 2009 Signature of appellant or attorney Notice Designating Record on Appeal (Limited Civil Case) APP-103, Page 6 of 6