CRCCP FORM 4 SC 3 / 18 NOTICE OF APPEAL County Court County, Colorado Court Address: Plaintiff(s): v. Defendant(s): COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom NOTICE OF APPEAL To: The County Court in and for the County of , State of Colorado and the above named . Please take notice that the undersigned will file an appeal. By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledgin g that I have made a change to the original content of this form. Said appeal will be docketed in the District Court pursuant to Rule 411, Rules of County Court Civil Procedure. Done this day of , 2 0 . Signature(s) of Appellant(s) Signature of Attorney for Appellant(s), if applicable Name, Address(es) of Appellant(s) Telephone Number(s) of Appellant(s) CERTIFICATE OF MAILING I certify that a true copy of the Notice of Appeal and the Designation of Record on Appeal was mailed, postage prepaid, to (opposing party(ies) or attorney), at (address), on (date). Appellant(s) or Attorney for Appellant(s) American LegalNet, Inc. www.FormsWorkFlow.com