THIS COURT REQUIRES THAT THE ATTACHED DOCKETING STATEMENT BE COMPLETED AND RETURNED TO THIS COURT 1. Appellant/Petitioner: If this case is an original writ, an appeal of a nonfinal order or a case involving child custody, this docketing statement must be completed and returned within 5 days. IN ALL OTHER CASES, the appellant must file the docketing statement within 20 days from the date of the acknowledgment of the notice of appeal. 2. Appellee/Respondent: Is not required to file a docketing statement unless there are amendments, corrections or additions to the docketing statement filed by the appellant/petitioner. Appellee/respondent is only required to file a notice of appearance if counsel=s name does not already appear on the certificate of service. Appellee=s/respondent=s docketing statement, if necessary is due within 5 days from service of the appellant=s/petitioner=s docketing statement. 3. REQUIRED: You must file the original docketing statement. Parties are not to file motions to dismiss addressed at compliance with the docketing statement requirements. The court will monitor its policies regarding the docketing statements. 4. American LegalNet, Inc. www.FormsWorkflow.com IN THE DISTRICT COURT OF APPEAL OF THE STATE OF FLORIDA FOURTH DISTRICT DOCKETING STATEMENT AND NOTICE OF APPEARANCE OF COUNSEL (Revised as of May 1, 2001) The Court requires the following information in order to facilitate disposition of the case. APPELLANT/PETITIONER: If this case involves an original writ, is an appeal of a non-final order or is a case involving child custody, this docketing statement must be completed and returned within five days. In all other cases, the appellant must file the docketing statement within 20 days from the date of the acknowledgment of the notice of appeal. APPELLEE/RESPONDENT: Is not required to file a docketing statement unless there are amendments, corrections or additions to the docketing statement filed by the appellant/petitioner. Appellee/respondent is only required to file a notice of appearance if counsel's name does not already appear on the certificate of service. Appellee's/respondent's docketing statement, if necessary, is due within 5 days from service of the appellant's/petitioner's docketing statement. PLEASE PROVIDE THE FOLLOWING INFORMATION: DOCKETING STATEMENT OF: (CHECK ONE) APPELLANT/PETITIONER ______ APPELLEE/RESPONDENT ______ 1. STYLE OF CASE DCA CASE NUMBER LOWER COURT CASE NUMBER 2a. NOTICE OF APPEARANCE OF COUNSEL FOR APPELLANT (If party is not represented by counsel, party should so indicate and provide accurate mailing address and phone number). Name____________________________________________________________ Bar Number____________________ Address ________________________________________________________________________________________ Attorney For_________________________Phone Number____________________Fax Number__________________ 2b. APPELLEE'S TRIAL COUNSEL AND/OR APPELLATE COUNSEL (IF KNOWN) Name____________________________________________________________ Bar Number____________________ Address ________________________________________________________________________________________ Attorney For_________________________Phone Number____________________Fax Number__________________ 3. INTERESTED PERSONS: List names of all persons or entities having an interest in this matter. Please clarify whether these persons or entities are parties, lawyers or otherwise, and as to parties, designate whether appellant or appellee. 2 American LegalNet, Inc. www.FormsWorkflow.com 4. JUDGES BELOW: List the name of all judges, deputy commissioners and hearing officers/examiners who were involved in this action below. Specify the judge who entered the order appealed. 5. JURISDICTION: State the basis for this court's jurisdiction, including the following: (1) the appellate rule providing jurisdiction claimed__________________; (2) the date of filing in the lower tribunal of the order appealed______________________; (3) if this is an appeal from a final order, the date of the return of verdict in a jury action_________________, the service date of any Fla. R. Civ. P. 1.530 motion_________________, and the date of entry of the order deciding such motion ________________. 6. PENDING MATTERS IN LOWER TRIBUNAL: Are there any matters, including counts of claims or counterclaims, still pending in the lower tribunal? If yes, please explain exactly what remains pending. 7. CURRENT AND PRIOR PROCEEDINGS IN THIS COURT: List by style and case number of this court, all cases which are or have been pending before this court involving issues arising from the same lower tribunal case and the current status of same: Criminal appeals: List by style and case number of this court all co-defendants currently or previously on appeal to this court. Similar Issues: List by style and case number of this court, all cases which are or have been pending before this court which are related to this action or which involve an issue which will be similar or determinative to the issue in this case on appeal. If you become aware of appeals filed subsequent to the submission of this docketing statement involving a co-defendant in a criminal case, the same controversy or parties, or substantial similar issues, please file an amended response to this question. 3 American LegalNet, Inc. www.FormsWorkflow.com 8. Court Transcript: Do you intend to order any portion of the transcript for the appeal? Yes______ No_______ If yes, have all arrangements been made for its preparation? Yes ______ No ______ If yes, date ordered _______________ If no, why not? _________________________________________________________ Estimated date of completion: ___________________ Estimated number of pages: ____________________ Name and address of court reporter(s): _____________________________________________ _____________________________________________ _____________________________________________ 9. CUSTODY STATUS IN CRIMINAL APPEALS: Is the appellant in custody and serving a sentence imposed as a result of a conviction which is the subject of this appeal? ________ If so, state the length of the sentence imposed. ___________________ 10. ISSUES: If this case involves the determination of the constitutionality of a statute, cite the statute involved. ___________________________. Please state in short form the anticipated issues raised. For example, on criminal issues: denial of motion for judgment of acquittal, denial of motion to suppress evidence, error in sentence; on civil issues, award of alimony, error in valuation of assets for equitable distribution, error in determining contract damages; error in admission of hearsay at trial. 11. TYPE OF CASE: PLACE A CHECK BY THE MOST APPROPRIATE TYPE OF CASE: A. Civil _____ 1. Domestic Relations - divorce, child custody, paternity or support _____ 2. Child dependency _____ 3. Adoption/Termination of Parental Rights _____ 4. Professional Malpractice _____ 5. Products Liability _____ 6. Negligence _____ 7. Contract or Indebtedness _____ 8. Condominium - rules violations, developer suits _____ 9. Foreclosure - mortgage, lien _____ 10. Inmate Appeal - gain time, rule challenges, disciplinary action _____ 11. Attorney's Fees 4 American LegalNet, Inc. www.FormsWorkflow.com _____ 12. All others - specify __________________________________ B. Criminal _____ 1. Direct Appeal - judgment and sentence _____ 2. Direct Appeal - sentence only _____ 3. Direct Appeal - juvenile _____ 4. Collateral Attack - (Rule 3.850 or habeas corpus) - judgment and sentence _____ 5. Collateral Attack - (Rule 3.800, Rule 3.850 or habeas corpus) - sentence only _____ 6. Collateral Attack - juvenile _____ 7. Appeal by the State _____ 8. All Others - specify __________________________________ C. Administrative _____ 1. Department of Professional Regulation _____ 2. Unemployment Appeals Commission _____ 3. Rule Challenge - specify agency _______________________ _____ 4. All others - specify __________________________________ Certificate of Service of I certify that a copy hereof has been furnished by _________________________ this_______ day mail/hand delivery/fax , 20____, to: . _________________________________ (Signature) _________________________________ (Print Name) 5 American LegalNet, Inc. www.FormsWorkflow.com