Form 1. Notice of Appeal (Tax, Civil, Family (Except Juvenile Cases), and Probate). SUPERIOR COURT OF THE DISTRICT OF COLUMBIA NOTICE OF APPEAL (______CROSS APPEAL) TAX, CIVIL, FAMILY (EXCEPT JUVENILE CASES) , AND PROBATE Superior Court Case Caption: ___________________________________________ _______ Superior Court Case No.:________________________________________________ ______ A. Notice is given that (person appealing)_______________________________ ___ is appealing an order/judgment from the:  Tax Division  Civil Division Family Court Probate Division 1. Date of entry of judgment or order appealed from (if more than one judgment or order appealed, list all): ________________________________________________________________________ ___ 2. Filing date of any post-judgment motion: _________________________________ 3. Date of entry of post-judgment order:_____________________________________ 4. Superior Court Judge: ______________________________________________ __ 5. Is the order final (i.e., disposes of all claims and has been entered by a Superior Court Judge, not a Magistrate Judge)?  YES  NO If no, state the basis for jurisdiction: _______________________________ ___ Has there been any other notice of appeal filed in this case:  YES NO If so, list the other appeal numbers:____________________________________ 6. If this case was consolidated with another case in this court, list the parties names and the Superior Court case number: ___________________________________________________ B. Type of Case:  Civil I Civil II Landlord and Tenant Neglect TPR Adoption Guardianship Mental Health Probate Intervention C. Indicate Status of Case:  Paid  In Forma Pauperis CCAN Was counsel appointed in the trial court?  YES NO D. Provide the names, addresses, and telephone numbers of all parties to be served. For persons represented by counsel, identify counsel and whom the counsel represents. For American LegalNet, Inc. www.USCourtForms.com>>>> 2 2 each person, state whether the person was a plaintiff or defendant in the Superior Court (use additional sheets of paper if necessary): NAME ADDRESS PARTY STATUS TELEPHONE (Plaintiff, Defendant) NOS. ______________ ______________ ___________________ _______________ ______________ ______________ ___________________ _______________ ______________ ______________ ___________________ _______________ E. Identify the portions of the transcript needed for appeal, including the date of the proceeding, the name of the Court Reporter (or state that the matter was recorded on tape if no Court Reporter was present), the courtroom where the proceeding was held, and the * date the transcript was ordered, or a motion was filed for preparation of the transcript. Attach additional pages if needed. Date of Proceeding/Portion Reporter/Courtroom Date ordered ____________________________ _______________________ ______________ ____________________________ _______________________ ______________ ____________________________ _______________________ ______________ ____________________________ _______________________ ______________  Check this box if no transcript is needed for this appeal. F. Person filing appeal: Plaintiff Pro Se  Defendant Pro Se Third Party/Intervenor  Counsel for Plaintiff Counsel for Defendant ATTACH A COPY OF THE ORDER, JUDGMENT OR DOCKET ENTRY FROM WHICH THIS APPEAL IS TAKEN _________________________________ ____________________________ ________ Print Name of Appellant/Attorney Signature Bar No. _________________________________ ___________________________________ Address Telephone Number * Appellant is responsible for ordering transcript(s) from the Court Reporting and Central Recording Division, Room 5500. If appellant has been granted In Forma Pauperis status, or had an attorney appointed by the Family Court, and transcript is needed for this appeal, appellant must file a Motion for Transcript in the Appeals Coordinators Office, Room 3148. That office number is (202) 879-1731. If that motion is granted, transcript will be prepared at no cost to appellant. American LegalNet, Inc. www.USCourtForms.com