NAME AND ADDRESS OF PARTY OR ATTORNEY FOR PARTY: TELEPHONE NUMBER: FOR COURT USE ONLY ATTORNEY FOR (NAME): SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 939 West Main Street, El Centro, CA 92243 220 Main Street, Brawley, CA 92227 415 East Fourth Street, Calexico, CA 92231 2124 Winterhaven Dr., Winterhaven, CA 92283 PLAINTIFF(S): DEFENDANT(S): NOTICE OF APPEAL; NOTICE OF FILING OF APPEAL SMALL CLAIMS (CCP § 116.710) CASE NUMBER: To: Plaintiff (Name and address): To: Defendant (Name and address): To: Plaintiff (Name and address): To: Defendant (Name and address): NOTICE OF APPEAL I appeal to the superior court, as provided by law from the small claims judgment, or the denial of the motion to vacate the small claims judgment. Date Appeal Filed (clerk to insert date): ___________________________________ (TYPE OR PRINT NAME OF APPELLANT) ________________________________________ (SIGNATURE OF APPELLANT OR APPELLANT’S ATTORNEY) I am an insurer of defendant (name) ________________________________ in this case. The judgment against defendant exceeds $2,500, and the policy of insurance with the defendant covers the matter to which the judgment applies. ________________________________ __________________________________________ (NAME OF INSURER) (SIGNATURE OF DECLARANT) NOTICE OF FILING OF APPEAL Your small claims case as been APPEALED to the superior court. Do not contact the small claims court about this appeal. The superior court will notify you of the date you should appear in court. The notice of appeal is set forth below. La decision hecha por la corte para reclamos judciales menores en su caso ha sido APELADA ante la corte superior. No se ponga en contacto con la corte para reclamos judiciales menores acerca de esta apelación. La corte superior le notificar las fecha en que usted debe presentarse ante ella. El aviso de la apelación aparece a continuación. Date: _________________ Kristine S. Kussman, Clerk, by ________________________________, Deputy CLERK’S CERTIFICATE OF MAILING I certify that I am not a party to this action. This Notice of Appeal and Notice of Filing of Notice of Appeal were plaintiff defendant at the address(es) stated mailed first class, postage prepaid, in a sealed envelope to above. The mailing and this certification occurred at (place) _______________, California on (Date): ________. Date: _________________________ Kristine S. Kussman, Clerk, by ________________________________, Deputy Form Approved for Optional Use SC-02 (1 of 1) (01/01/11) American LegalNet, Inc. www.FormsWorkFlow.com