APPEAL - CIVIL INSTRUCTIONS 1. Prepare on typewriter. 2. Sign "Appeal" and "Certification" sections, marked by X below. 3. Submit the original to the trial court clerk, who shall endorse it and return an endorsed photocopy to counsel. 4. The trial court clerk shall send a copy of the endorsed appeal form to the trial judge. 5. Counsel shall file the endorsed copy of the appeal form, along with the papers JD-SC-28 Rev. 2-99 P.B. §§ 3-8, 62-8, 63-3, 63-4, 63-10 C.G.S. §§ 51-197f, 52-470 TO SUPREME COURT TO APPELLATE COURT NAME OF CASE (State full name of case as appears in judgment file) CLASSIFICATION APPEAL CROSS JOINT APPEAL AMENDED APPEAL COURT APPEAL CORRECTED/ AMENDED APPEAL FORM STIPULATION FOR APPEAL TRIED TO CONSOLIDATED RESERVATION OTHER (Specify) TRIAL COURT LOCATION JURY TRIAL COURT JUDGE LIST ALL TRIAL COURT DOCKET NUMBERS JUDGMENT FOR (Where there are multiple parties, specify any individual party(ies) for whom judgment may have been entered.) PLAINTIFF TRIAL COURT HISTORY JUDGMENT DATE DEFENDANT OTHER: DATE FOR FILING EXTENDED APPEAL DATE OF ISSUANCE OF NOTICE ON ANY ORDER ON ANY MOTION WHICH WOULD RENDER JUDGMENT INEFFECTIVE CASE TYPE JUVENILE HABEAS CORPUS CIVIL: Major/Minor code FAMILY WORKERS COMPENSATION OTHER DATE CERTIFICATION GRANTED For habeas corpus or zoning appeals indicate the date certification was granted: APPEAL FILED BY (Where there are multiple parties, specify the name of the individual party(ies) filing this appeal.) PLAINTIFF DEFENDANT OTHER FROM (the action which constitutes the final judgment): APPEAL IF TO SUPREME COURT, STATUTORY BASIS FOR THE APPEAL (C.G.S. § 51-199) BY (Signature of attorney or pro se party) TELEPHONE NO. FAX NO. JURIS NO. (If applicable) X TYPE NAME AND ADDRESS OF PERSON SIGNING ABOVE (This is your appearance; see P.B. § 62-8) "X" ONE IF APPLICABLE APPEARANCE Pursuant to P.B. § 62-8, counsel who files this appeal shall be deemed to have appeared in addition to counsel of record who appeared in the trial court. NAME OF COUNSEL AND JURIS NO. Pursuant to P.B. § 3-8 counsel who files this appeal is appearing in lieu of: INDICATE WHICH OF THE FOLLOWING ARE ATTACHED BY PLACING AN "X" IN THE PROPER BOX(ES) 1. PRELIMINARY STATEMENT OF THE ISSUES CERTIFICATION (P.B. § 63-3) 2. PRELIMINARY DESIGNATION OF PLEADINGS 6. DRAFT JUDGMENT FILE 3. COURT REPORTER'S ACKNOWLEDGMENT/ CERTIFICATE RE TRANSCRIPT 4. DOCKETING STATEMENT ATTACHMENTS 5. STATEMENT FOR PREARGUMENT CONFERENCE 7. CONSTITUTIONALITY NOTICE I HEREBY CERTIFY THAT A COPY HEREOF WAS SERVED ON ALL COUNSEL AND PRO SE PARTIES OF RECORD IN ACCORDANCE WITH THE PROVISIONS OF P.B. § 62-7 ON:* DATE 8. DS1 (DOCKET SHEETS) SIGNED (Individual counsel) X * Attach list with name, address, telephone and facsimile numbers of each counsel and pro se party served. TO BE COMPLETED BY TRIAL COURT CLERK COURT USE ONLY - FILE DATE Entry Fee Paid No Fees Required Fees, Costs, and Security waived by Judge: JUDGE DATE SIGNED (Clerk of trial court) 2000 (C) American LegalNet, Inc. SETTLEMENT MATERIAL - CONFIDENTIAL STATEMENT FOR PREARGUMENT CONFERENCE CONNECTICUT JUDICIAL BRANCH APPELLATE CLERK 231 CAPITOL AVENUE P.O. DRAWER Z, STATION A HARTFORD CT 06106 JD-SC-28 (Page 2) Rev. 2-99 INSTRUCTIONS 1. Prepare on typewriter; serve copies on opposing counsel (P.B. § 62-7) 2. List on the reverse side of form the names and addresses of opposing counsel and pro se parties that have been served with a copy of this form. 3. If you are the appellant, you are required to attach a copy of the trial court's written memorandum of decision or a transcript of the trial court's oral decision pursuant to P.B § 64-1. 4. Submit in duplicate to the Appellate Clerk at the address shown. NAME OF CASE(S) FOR COURT USE ONLY (Docket Numbers) CASE TYPE BRIEFLY DESCRIBE THE FINAL JUDGMENT/RULING APPEALED PARTY OR PARTIES APPEALING TELEPHONE NO. ATTORNEY OR PRO SE PARTY FILING STATEMENT FOR PREARGUMENT CONFERENCE/JURIS NO. ADDRESS (No., street, town, state and zip) FILING STATUS (Check all that apply) ATTORNEY PRO SE APPELLANT CROSS-APPELLANT 1. State the issues you intend to present on the appeal or cross-appeal or, alternatively, attach a copy of your Preliminary Statement of the Issues to this form (P.B. §§ 61-8, 63-4). Continue on separate page if necessary. YES 2. If this appeal was filed in the Appellate Court, should it be transferred to the Supreme Court? 3. Would you be willing to waive oral argument in this case? YES NO NO (EXPLAIN BELOW) 4. Have you attached a copy of the memorandum of decision or a transcript of oral decision? YES NO (EXPLAIN BELOW) NOTICE TO COUNSEL The failure to file this form, or the failure to attend a preargument conference, may result in the imposition of sanctions (P.B. §§ 85-2, 85-3). It is the duty of counsel to communicate with each other to assure attendance at the conference. I hereby certify that a copy of the above was mailed to all counsel and pro se parties of record in accordance with the provisions of Practice Book section 62-7. SIGNATURE OF INDIVIDUAL COUNSEL/PRO SE DATE SIGNED 2000 (C) American LegalNet, Inc.