Page 1 Signature of individual counsel/self-represented party u Names, addresses and numbers included on separate page. CONNECTICUT JUDICIAL BRANCH APPELLATE CLERK 231 Capitol Avenue Hartford, CT 06106 1.If this appeal was filed in the Appellate Court, should it be transferred to the Supreme Court?2.Would you be willing to waive oral argument in this case? Date signed Notice It is the duty of counsel and self-represented parties to communicate with each other to assure attendance at the conference. If you do not file this form, or do not attend a scheduled preargument conference, sanctions under Practice Book Section 85-2 may be imposed (See Practice Book Section 63-10). I certify that a copy of the document(s) that I am filing has been delivered to each other counsel and self-represented party of record and I have included their names, addresses, e-mail addresses, and telephone and facsimile numbers, and that the ADA NOTICE The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA.1.Fill out this form and hand deliver or mail a copy to all counseland self-represented parties (see Practice Book Section 62-7). 2.File this form by hand delivering it or mailing it to the AppellateCross appellant Appellant Self-represented party Attorney Filing status (Check all that apply) Address (Number, street, city/town, state and ZIP) Telephone number Attorney or self-represented party filing preargument conference statementParty or parties appealing Briefly describe the final judgment/ruling appealed Case type For Court use only (Docket Numbers) Name of case(s) E-mail address Name of person signing at left No Yes (Explain below) No Yes American LegalNet, Inc. www.FormsWorkFlow.com