NO. [Docket Number in Reviewing Court] IN THE APPELLATE COURT OF ILLINOIS [CHOOSE ONE] ) ) ) ) ) ) ) Appeal from ______________ County Circuit Number __________________ Trial Judge ______________________ Date of Judgment _________________ Date of Posttrial Order _____________ Date of Notice of Appeal ________________________________ Felony __ Misdemeanor __ In Custody __ Out on Bond __ Plaintiff-Appellant, ) v. ) Defendants-Appellees. ) DOCKETING STATEMENT (Criminal) 1. Full name and complete address of appellant(s) filing this statement: Name: Address Telephone: Email address: Counsel on Appeal for appellant(s) filing this statement: ARDC # Name: Address: Telephone: Email address: 2. Full name and complete address of appellee(s): Name: Address: Telephone: Counsel on Appeal for appellee(s): Name: Address: American LegalNet, Inc. www.FormsWorkFlow.com Telephone: ARDC # if known: Email address: Court reporting personnel: (If more space is needed, use other side.) Name: Address: Telephone: Email address: General statement of issues proposed to be raised: (Failure to include an issue in this statement will not result in the waiver of the issue on appeal): I hereby certify that on the ____ day of __________, 20__, I As [choose one] ___asked____made a written request to the clerk of the circuit court to prepare the record on appeal, on the ____ day of __________, 20__, I made a written request to the court reporting personnel to prepare the transcript(s). Date [choose one] __ In lieu of court reporting personnel's signature I have attached the written request to the court reporting personnel to prepare the transcript(s). Date [choose one] __ I hereby acknowledge receipt of an order for the preparation of a report of proceedings. Date Court Reporting Personnel or Supervisor Revised December 11, 2014 American LegalNet, Inc. www.FormsWorkFlow.com