UNITED STATES DISTRICT COURT WESTERN DISTRICT OF MISSOURI NOTICE OF APPEAL United States of America Plaintiff vs. Defendant Case Number District Court Judge Notice is hereby given that appeals to the United States Court of Appeals for the Eighth Circuit From the: G Judgment & Commitment G Order Specify entered on this action on ____________. Date Name of Counsel Telephone Number Street Address SSN (for CJA compensation) City State Zip Signature of Attorney Date TRANSCRIPT ORDER FORM To be completed by attorney for appellant G Please prepare transcript of: G Pretrial proceedings G Testimony or G Portions thereof G Sentencing G Post-trial proceedings G Other G No transcript ordered: Reason: G Previously filed G Other CERTIFICATE OF COMPLIANCE Appellant hereby certifies that copies of this notice of appeal/transcript order form have been filed/served upon U.S. District Court, court reporter, and all counsel of record, and that satisfactory arrangements for payment of cost of transcripts ordered have been made with the court reporter. (FRAP 10(b)). Method of payment: G Funds G CJA Form 24, completed and attached Attorney's signature (See Reverse) Date American LegalNet, Inc. www.FormsWorkFlow.com INFORMATION SHEET To be Completed by Attorney for Appellant 1. 2. Defendant's Address: Date of verdict: Offenses: Trial Testimony Number of days Bail Status: Jury G Non jury G 3. 4. Sentence and Date Imposed: Date Trial Transcripts Ordered by Counsel or District Court: Stenographer in Charge (Name, Address and Telephone Number): 5. Trial Counsel was G appointed G retained Does Defendant's financial status warrant appointment of counsel on appeal? Affidavit of financial status filed: Is there any reason why trial counsel should not be appointed as counsel on appeal? 6. Assistant U.S. Attorney name and telephone number: COURT REPORTER ACKNOWLEDGMENT Date Order Received Estimated Completion Date Estimated # of Pages Court Reporter's Signature Date American LegalNet, Inc. www.FormsWorkFlow.com