CCT402 State ENG Rev 10/17www.mncourts.gov/formsPage 1 of 2 County of: Select County Court File Number: Judicial District: Case Type: Conciliation Conciliation CourtState of Minnesota Name: Address: City/State/Zip Name: Address: City/State/Zip Defendant #1Plaintiff #1 Name: Address: City/State/Zip Name: Address: City/State/Zip Plaintiff #2P L E A S E P R I N T VS. VS. Defendant #2Demand for Removal/Appeal From Conciliation Court to District Court and Affidavit of Good Faith To the above named Plaintiff Defendant. (Appellant or Attorney), states: That the appealing party is aggrieved by the judgment in Conciliation Court and hereby demands the removal of the above case from Conciliation Court to the District Court for trialDe Novo (new trial) by court jury.ANDThat this appeal is made in good faith and not for the purpose of delay. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. 247 358.116 Date: Signature of Attorney or the Party if pro se If appealing party is a corporation, the party's attorney must sign Name of Attorney, or party if pro se: Address: City/State/Zip: Telephone: E-mail address: County and State where signed American LegalNet, Inc. www.FormsWorkFlow.com CCT402 State ENG Rev 10/17www.mncourts.gov/formsPage 2 of 2 County of: Select County Court File Number: Judicial District: Case Type: Conciliation Affidavit of Service , state the following: I am at least eighteen (18) years of age and not a party to the above-entitled matter. On (date) I served the attached Demand for Removal/Appeal From Conciliation Court to District Court and Affidavit upon by: (Name of opposing party served or opposing party's lawyer) Check one: (Personal Service) (Substituted Personal Service) (Personal Service on a Corporation or a Partnership) (Service by First Class Mail) Placing in an envelope a true and correct copy of each document addressed to at in the City of , State of , Zip Code and depositing the envelope, with sufficient postage, in the United States Mail at the Post Office located in the City of , in the State of . Personally by handing to and leaving with him/her a true and correct copy. At his/her usual abode at (Street, City, State)by handing to and leaving a true and correct copy with a person of suitable age, (eighteen (18) years or older) and discretion who also resides at that address. Personally delivering true and correct copy to: Agent authorized to receive service of Process: (Name of agent served) Officer, Managing Agent, or Member of the entity: (Name and title of person served) Signature of person who served papersI declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116.State of Minnesota Conciliation Court County and State where signed American LegalNet, Inc. www.FormsWorkFlow.com