Information on Appeal Procedures for Infractionswww.courts.ca.gov/formswww.courts.ca.gov/forms Clerk stamps date here when form is filed. You fill in the number and name of the trial court case in which you are appealing the judgment or order:You fill in the name and street address of the courtthat issued the judgment or order you are appealing:The clerk will fill in the number below: (if different): City State Street Zip Street City State Zip (if different): City State Street Zip Street City State Zip www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com (complete item below) skip item ; sign and date this form(check a or b): 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 223oral proceedings224). 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 an error was made in those proceedings.(Write initials here): (Write initials here): (At the top of each page write CR-142, item 3.224)(check a, b, or c): (fill in the date): (fill in the date): (check and complete only onea, b, c, or d): A statement on appeal is a summary of the trial court proceedings approved by the trial court. See form CR-141-INFO for information about preparing a proposed statement. (Check and complete (1) or (2).) American LegalNet, Inc. www.FormsWorkFlow.com This option is available only if an official electronicrecording 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. Some courts also have local rules that establish procedures for determining whether only a portion of a transcript or a different form of the record will be sufficient for an effective appeal. Check with the trial court to see if it has such a local rule. (Check and complete (1) or (2).) Defendant222s Financial Statement on Eligibility for Appointment of Counseland Reimbursement and Record on Appeal at Public Expense (You can get form MC-210 at any courthouse or county law library or online atThe court will review this form to decide if you are eligible for a free transcript.) If you are not represented by a lawyer in this appeal, you must use(form CR-143)to prepare and file this proposed statement. You can get form CR-143 at any courthouse or county law library or onlineat (continued) This option is available only ifan official electronic recording was made of what was said in the trial court, the court has a local rule for the appellate division permittingthe use of the official electronic recording itself as the record of the court proceedings, and you and the respondent (the prosecuting agency) have agreed (stipulated) that you want to use the recording itself as the record of what was said in your 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 respondent to thisnotice. (Check and complete (1) or (2).) Defendant222s Financial Statement on Eligibility for Appointment of Counsel and Reimbursement and Record on Appeal at Public Expense (You can get form MC-210 at any courthouse or county law library or online atThe court will review this form to decide if you are eligible for a free copy of the official electronic recording.) American LegalNet, Inc. www.FormsWorkFlow.com Type or print your name (continued)Signature of appellant or attorney 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. Some courts also have local rules that establish procedures for determining whether only a portion of the reporter222s transcript or a different form of the record will be sufficient for an effective appeal. Check with the trial court to see if it has such a local rule. Defendant222s Financial Statement on Eligibility for Appointment of Counsel and Reimbursement and Record on Appeal at Public Expense(You can get form MC-210 at any courthouse or county law library or online at .. The court will review this form to decide if you are eligible for a reporter222s transcript at no cost to you.) (check and complete one of the following) American LegalNet, Inc. www.FormsWorkFlow.com