SUPERIOR COURT OF CALIFORNIA, COUNTY OF NAPA 825 BROWN STREET NAPA, CALIFORNIA 94559 PLAINTIFF: DEFENDANT: CASE NUMBER NOTICE OF APPEAL AND REQUEST FOR TRIAL DE NOVO (LABOR COMMISSIONER) NOTICE OF APPEAL of the Order, Decision, or Award of the Labor Commissioner in State Case no. dated , and served upon the undersigned appellant , , , is given and filed pursuant to Labor Code section 98.2. by mail on Appellant attaches as Exhibit A, a copy of the Order, Decision, or Award appealed, and requests that the Clerk of the Court set the cause for hearing before the above-entitled court, where it shall be heard de novo in accordance with Labor Code section 98.2, and that the Clerk of the Court give notice of time, date, and place of the new trial to each of the following parties and the Labor Commissioner’s office at the places listed below. Appellant certifies that a copy of this Notice of Appeal has been served upon the Labor Commissioner, and a copy has been mailed to the Respondent, as shown below. APPELLANT (OR ATTORNEY) (NAME, ADDRESS, AND TELEPHONE NUMBER) OFFICE OF THE LABOR COMMISSIONER (ADDRESS AND TELEPHONE NUMBER) RESPONDENT (OR ATTORNEY) (NAME, ADDRESS, AND TELEPHONE NUMBER) Date Signature of Appellant NOTICE OF APPEAL AND REQUEST FOR TRIAL DE NOVO (LABOR COMMISSIONER) American LegalNet, Inc. www.USCourtForms.com