NO [Appellate Court No.] IN THE APPELLATE COURT OF ILLINOIS SECOND DISTRICT , Plaintiff-Appellant, v. , Defendants-Appellees. ) ) ) ) ) ) ) ) ) ) ) Appeal from ____________ County Circuit No. _____________ Trial Judge _____________ Date of Notice of Appeal _________ Date of Judgment _______________ Date of Order on Postjudgment Motion________________________ 1. Is this a cross-appeal, separate appeal, joining in a prior appeal, or related to another appeal which is currently pending or which has been disposed of by this Court? If so, state the docket number(s) of the other appeal(s): ____________________________________________ _____________________________________________________________________________ 2. If any party is a corporation or association, identify any affiliate, subsidiary, or parent group: _______________________________________________________________________ [IF NOT APPLICABLE, STATE “NOT APPLICABLE”] 3. Full name of appellant filing this statement: ___________________________________ For appellant filing this statement: Name: ___________________________________________________________ Address: ___________________________________________________________ ___________________________________________________________ Telephone: ________________________; Fax: ______________________________ 4. For appellees (if there are multiple appellees represented by different counsel, identify separately): Name: Address: Telephone: ___________________________________________________________ ___________________________________________________________ _________________________; Fax:______________________________ American LegalNet, Inc. www.FormsWorkFlow.com 5. Court reporters (if more space is needed, use other side): Name: Address: Telephone: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Approximate duration of trial court proceedings to be transcribed: ________________________ Can this appeal be accelerated? ___________________________________________________ 6. Briefly state the Supreme Court Rule, or other law, which confers jurisdiction upon the reviewing Court; the facts of the case which bring it within this rule or other law; and the date that the order being appealed was entered and any other facts which are necessary to demonstrate that the appeal is timely: 7. Nature of case: Administrative Review Contract Estates Personal Injury Tort Juvenile ______ ______ ______ ______ ______ Domestic Relations Child Custody or Support Product Liability Forcible Detainer Other: _____ _____ _____ _____ 8. Briefly describe the nature of the case and the result in the trial court, and set forth any reasons for an expedited schedule: 9. State the general issues proposed to be raised: I, as appellant attorney for the appellant, certify that on written request to the Clerk of the Circuit Court to prepare the record, and on written request to the court reporter to prepare the transcripts. ___________________________ Date , I made a , I made a __________________________ __________ Appellant, Attorney for Appellant In lieu of a reporter’s signature I have attached the written request to the court reporter to prepare the transcript. ___________________________ Date ______________________________ ______ American LegalNet, Inc. www.FormsWorkFlow.com