FORM NO. 8-A NOTICE OF APPEAL IN THE CIRCUIT COURT OF Judge or Division: COUNTY, MISSOURI Case Number: Plaintiff/Petitioner: Appellate Number: Filing as an Indigent Court Reporter: Sound Recording Equipment vs. Reporter's Telephone: Number of Days of Trial: Date of Judgment/Sentence: Date Post Trial Motion Filed: Defendant/Respondent: (Attach a copy) Date Ruled Upon: Date Notice Filed: (Date File Stamp) Notice of Appeal Western Court of Appeals: Supreme Court of Missouri Notice is given that Eastern Southern appeals from the judgment/decree entered in this action on (date). Complete if Appeal is to Supreme Court of Missouri Jurisdiction of the Supreme Court is based on the fact that this appeal involves: (Check appropriate box) The validity of a treaty or statute of the United States The title to any state office in Missouri The construction of the revenue laws of Missouri The punishment imposed is death The validity of a statute or provision of the Constitution of Missouri If the basis of jurisdiction is validity of a United States treaty or statute, the validity of a Missouri statute or Constitutional provision or construction of Missouri revenue laws, a concise explanation, together with suggestions, if desired, is required. This may be filed as part of or with this notice of appeal or, in the alternative, may be filed within ten days after the notice of appeal is filed by filing it directly with the Clerk of the Supreme Court. See Rule 81.08(b) and (c) and Rule 30.01(f) and (g). Respondent's Attorney(s)/Bar Number(s) Appellant's Attorney/Bar Number (If multiple, list all or attach additional sheets) Address Telephone Address Fax Telephone Appellant's Name Respondent's Name Address Address Telephone Fax Telephone Brief Description of Case Date of Appeal Bond Signature of Attorney or Appellant Amount of Bond Bond Attached Date American LegalNet, Inc. www.USCourtForms.com Notice to Appellant's Attorney Local rules may require supplemental documents to be filed. Please refer to the applicable rule for the district in which the appeal is being filed and forward supplements as required. Directions to Clerk Serve a copy of the notice of appeal in a manner as prescribed by Rule 43.01 on the attorneys of record of all parties to the judgment other than those taking the appeal and on all other parties who do not have an attorney. (A copy of the notice of appeal is to be sent to the Attorney General when the appeal involves a felony.) Transmit a copy of the notice of appeal to the clerk of the Supreme Court/Court of Appeals. If a party does not have an attorney, mail the notice to the party at his/her last known address. Clerk shall then fill in the memorandum below. (See Rules 81.08(d) and 30.01 (h) and (i).) Forward the docket fee to the Department of Revenue as required by statute. Memorandum of the Clerk I have this day served a copy of this notice by regular mail registered mail certified mail facsimile transmission to each of the following persons at the address stated below. If served by facsimile, include the time and date of transmission and the telephone number to which the document was transmitted. I have also transmitted a copy of the notice of appeal to the clerk of the Court of Appeals, Supreme Court Docket fee in the amount of $ District has been received by this clerk which will be disbursed as required by statute. A copy of an order granting leave to appeal as indigent. Clerk By: Date Deputy Clerk American LegalNet, Inc. www.USCourtForms.com