JUSTICE COURT, LAS VEGAS TOWNSHIP Clark County, Nevada Name of Plaintiff(s) Case No. Department No. (Plaintiff's(s') Telephone Number & E-mail Address) NOTICE OF APPEAL VERSUS Name of Defendant(s) (Defendant's(s') Telephone Number & E-mail Address) The (Plaintiff or Defendant) In the above entitled matter APPEALS TO THE Eighth Judicial District Court, day of , 20 in the above Clark County, Nevada from the judgment entered on the entitled Court. DATE: Appellant's Signature CERTIFICATION OF MAILING The Undersigned certifies on the mailed to day of at by depositing a copy in the United States Mail in an addressed sealed envelope, postage prepaid. Date): (Type or Print Name:) (Signature) , 20 , a copy of the foregoing NOTICE OF APPEAL was Per NRS 53.045, "I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct." (Signature): __________________________________________ ___________________________________________ Original-File Revised 6/12 (Date): LVJCVL-12 Form American LegalNet, Inc. www.FormsWorkFlow.com