NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NUMBER Reserved for Clerk’s File Stamp ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS: PLAINTIFF: DEFENDANT: CASE NUMBER: NOTICE OF APPEAL AND NOTICE OF FILING NOTICE OF APPEAL (Limited Civil) NOTICE OF APPEAL ____________________________________________________________________________________________________________________________________________ (Appellant’s Name) (Plaintiff/Defendant) in the above-entitled action hereby appeal to the Appellate Division of the Superior Court for the County of Los Angeles, State of California, from the _____________________________________ entered in the above-named Superior Court on _____________________in (Judgment/Order) Division/Dept. _____________________in favor of _______________________________________. Dated: ____________________ _________________________________________________________________ (Signature of Appellant or Appellant’s Attorney NOTICE Of FILING NOTICE OF APPEAL To: _____________________________________________________________________ To: _____________________________________________________________________ YOU AND EACH OF YOU WILL PLEASE TAKE NOTICE that on ______________________ in the above-entitled action the appellant filed with the Clerk of the above-named Court the above NOTICE OF APPEAL. JOHN A. CLARKE, Executive Officer/Clerk Dated: ____________________ By: ____________________________________________________________________ Deputy Clerk CERTIFICATE OF MAILING I, the below named Executive Officer/Clerk of the above-entitled court, do hereby certify that I am not a party to the cause herein, and that on this date I served the Notice of Filing Notice of Appeal upon each party or counsel named below by depositing in the United States mail at the courthouse in __________________________, California, one copy of the original filed/entered herein in a separate sealed envelope to each address as shown below with the postage thereon fully prepaid. JOHN A. CLARKE, Executive Officer/Clerk Dated: ____________________ CIV 114 03-04 (Rev. 01/07) LASC Approved By: _______________________________________ Deputy Clerk NOTICE OF APPEAL AND NOTICE OF FILING NOTICE OF APPEAL Code Civ. Proc,, § 1013a(3), Cal. Rules of Court, rule 8.750(a) & (b) American LegalNet, Inc. www.FormsWorkflow.com