UNITED STATES DISTRICT COURT EASTERN DISTRICT OF CALIFORNIA Transcript Designation and Ordering Form U.S. Court of Appeals Case No. U.S. District Court Case No. Short Case Title Date Notice of Appeal Filed by Clerk of District Court SECTION A - To be com pleted by party ordering transcript HEARING DATE COURT REPORTER PROCEEDINGS (Please Specify) (attach additional page for designations if necessary) ( ) I do not intend to designate any portion of the transcript and will notify all counsel of this intention. ( ) As retained counsel (or litigant proceeding in pro per), I request a copy of the transcript and guarantee paym ent to the reporter of the cost thereof upon dem and. I further agree to pay for work done prior to cancellation of this order. ( ) As appointed counsel I certify that an appropriate order authorizing preparation of the transcript at the expense of the United States has been, or within 5 days hereof will be, obtained and delivered to the reporter. I agree to recom m end paym ent for work done prior to cancellation of this order. Date transcript ordered Type or Print Nam e Signature of Attorney Phone Num ber Address: SECTION B - To be com pleted by court reporter I, have received this designation. (Signature of court reporter) ( ) Arrangem ents for paym ent were m ade on ( ) Arrangem ents for paym ent have not been m ade pursuant to FRAP 10(b). Approxim ate Num ber of Pages in Transcript - Due Date SECTION C - To be com pleted by court reporter W hen the transcript is filed, com plete this copy and subm it it to the U.S. District Court with the com pleted transcript. District Court will not file the transcript without this com pleted form . Date Transcript Filed Court Reporter’s Signature SECTION D U.S. DISTRICT COURT CLERK: I certify that the record is available in the office of the U.S. District Court. BY: (U.S. District Court Clerk) (date) DEPUTY CLERK American LegalNet, Inc. www.USCourtForms.com