This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Appellate Courts. Instructions THIS APPEAL INVOLVES A MATTER SUBJECT TO EXPEDITED DISPOSITION UNDER Check the box to the right if your case involves parental responsibility or parenting time (custody/visitation rights) or relocation of a child. RULE 311(a). Appellate Case No.: Enter the appellate c ourt case number. Just below "In the Appellate Court of Illinois," enter the number of the appellate district where the appeal was filed. IN THE APPELLATE COURT OF ILLINOIS District If the case name in the trial court began with "In re" (for example, "In re Marriage of Jones"), enter that phrase. If the case name did not begin with "In re," enter the names of the parties as they appeared in the trial court documents. Below each party name check either Appellant if the party filed the appeal or Appellee if the party is responding to the appeal. In re Appeal from the Circuit Court of County Trial Court Case No: Plaintiff/Petitioner in trial court (First, middle, last name) Appellant Appellee Trial Judge: D ate of Notice of Appeal: v. Date Judgment was entered: Defendant/Respondent in t rial c ourt (First, middle, last name) At the far right, enter the trial court county, trial court case number, the trial judge's name, date of the notice of appeal, date of the judgment, date of the ruling on any post-judgment motion, and the Supreme Court Rule that allows the appellate court to hear the appeal. Appellant Appellee Date Post - Judg ment Motion was ruled on: Supreme Court Rule : In 1, check "Yes" if this appeal is related to another appeal and write the docket (case) number of any other appeal. Check 223No224 if this appeal is not related to another appeal. DOCKETING STATEMENT (CIVIL) 1.003 Is this a cross - appeal, separate appeal, joining in a prior appeal, or related to another appeal that is currently pending or that has been decided by this court? Yes No If yes , list the docket numbers of the other appeals: DS - S 4603.1 Page 1 of 5003 (05/19 ) American LegalNet, Inc. www.FormsWorkFlow.com Enter the Case Number given by the Appellate Clerk: In 2, if any party, either Appellant or Appellee, is a corporation or business association, write the name of any company related to that corporation or business association. In 3, enter your full name and other contact information. If there are other appellants besides you, include all their names and contact information on the Additional Appellant Information form and attach it to this Docketing Statement (Civil) and put a check in the box. If you have a lawyer, fill in their information below 223Lawyer on Appeal for appellant filing this statement.224 If there is more than one lawyer for the appellants, check the box and fill out the Additional form. Insert it after this page . In 4, you must enter the full name and contact information for all appellees you are filing your appeal against. If there is more than one appellee, include all their names and contact information on the Additional Appellee Information form and put a check in the box. You must also enter the full name and contact information for each lawyer. If you don't know the name of an appellee's lawyer, fill in the name and address of their trial lawyer. If there is more than one appellee or more than one lawyer for the appellee, check the box and fill out the Additional Lawyer on Appeal Information form. Insert it after this page. 2. If any party is a corporation or association, identify any affiliate, subsidiary, or parent group: 3. Full name and complete address of appellant filing this statement: First Middle Last Street, Apt # Telephone number City State ZIP Email address I have listed additional appellants on the Additional Appellant Information form. Lawyer on Appeal for appellant filing this statement: First Middle Last Street , Apt # City State ZIP Lawyer Registration Number Telephone number Email address Fax number I have listed additional lawyers on the Additional Lawyer on Appeal Information form. 4. Full name and complete address of appellee: First Middle Street, Apt # Last Telephone number City State ZIP Email address I have listed additional appellees on the Additional Appellee Information form. Lawyer for appellee : First Middle Street , Apt # City State ZIP Lawyer Registration Number Last Telephone number Email address Fax number I have listed additional lawyers on the Additional Lawyer on Appeal I nformation form. DS - S 4603.1 Page 2 of 5 ( 05 /19 ) American LegalNet, Inc. www.FormsWorkFlow.com Enter the Case Number given by the Appellate Clerk: 5. Court reporter information: First003 Middle Last In 5, enter the name and address of the court reporter who recorded the hearing in the trial court. If the hearing was electronically recorded, contact the trial court clerk222s office to order the transcript. If there was no court reporter or recording, then leave 5 blank. In 5, if there was more than one court reporter, check the box and fill out the Additional Court Reporter Information form. Insert it before this page. In 6, check "Yes" if your case involves parental responsibility or parenting time (custody/visitation rights) or relocation of a child. There are special rules that apply to speed up these appeals. In 7, briefly write down your reasons for filing this appeal. If you don222t list a reason here, you will still be able to bring it up later. In 8a, enter the date you filed your Request for Preparation of Record on Appeal with the trial court. In 8b, enter the date you delivered your Request for Report of Proceedings (Transcripts) to the court reporter you listed above in 5. If there was no court reporter or recording, leave 8b blank. If you are completing this form on a computer, sign your name by typing it. If you are completing it by hand, sign and print your name. Street Address003 City State Zip Telephone003 Email address I have listed additional court reporters on the Additional Court Reporter Information form. 6.003 Is this appeal from a final order in a matter involving child custody, allocation of parental responsibilities, or relocation of a minor child under Illinois Supreme Court Rule 311(a), which requires Mandatory Accelerated Disposition ? Yes No If yes, this Docketing Statement (Civil) , and all other notices, briefs, motions, and pleadings filed by any party shall include the following statement in bold type on the top of the front page: THIS APPEAL INVOLVES A MATTER SUBJECT TO EXPEDITED DISPOSITION UNDER RULE 311(a). 7.003 State the general issues you want to raise in your appeal: 8.003 I certify that a.003 on this date I filed a request with the trial court clerk to Date prepare the appeal record on appeal. b.003 on this date I made a written request to the court reporting Date personnel to prepare the transcripts, a copy of which is attached to this Docketing Statement . /s/ Your Signature003 Street Address Print Your Name City, State, ZIP Telephone DS - S 4603.1 Page 3 of 5003 ( 05 /19 ) American LegalNet, Inc. www.FormsWorkFlow.com Enter the Case Number given by the Appellate Clerk: GETTING COURT DOCUMENTS BY EMAIL: If you agree to receive court documents by email, check the box below and enter your email address. You should use an email account that you do not share with anyone else and that you check every day. If you do not check your email every day, you may miss important information or notice of court dates. Other parties may still send you court documents by mail. I agree to receive court documents at this email address during my entire case. In 1a, enter the name, mailing address, and email address of the party or lawyer to whom you sent the document. In 1b, check the box to show how you sent the document, and fill in any other information required on the blank lines. CAUTION: If the other party does not have a lawyer, you may send the document by email only if the other party has listed their email address on a court document. Email PROOF OF SERVICE (Y ou must serve the other party and complete this section) 1.003 I sent this document: a.003 To:002 Name:002 First003 Middle Last Address: