Official Form 17 (12/04) United States Bankruptcy Court Northern District of Alabama In re _________________________, Debtor Case No. _______________________ Chapter _______________ [Caption as in Form 16A, 16B, or 16D, as appropriate] NOTICE OF APPEAL _____________________________________, the plaintiff [or defendant or other party] appeals under 28 U.S.C. § 158(a) or (b) from the judgment, order, or decree of the bankruptcy judge (describe) entered in this adversary proceeding [or other proceeding, describe type] on the ____________ day of , . (month) (year) The names of all parties to the judgment, order, or decree appealed from and the names, addresses, and telephone numbers of their respective attorneys are as follows: Dated: ____________________________ Signed: ___________________________________________________ Attorney for Appellant (or Appellant, if not represented by an Attorney) Attorney Name: ________________________________________ Address: ______________________________________________ _______________________________________________ Telephone No: _______________________________________________ If a Bankruptcy Appellate Panel Service is authorized to hear this appeal, each party has a right to have the appeal heard by the district court. The appellant may exercise this right only by filing a separate statement of election at the time of the filing of this notice of appeal. Any other party may elect, within the time provided in 28 U.S.C. § 158(c), to have the appeal heard by the district court. If a child support creditor or its representative is the appellant, and if the child support creditor or its representative files the form specified in § 304(g) of the Bankruptcy Reform Act of 1994, no fee is required. American LegalNet, Inc. www.FormsWorkFlow.com