IN THE SUPREME COURT OF THE STATE OF NEVADA Supreme Court No. ______________ District Court No. _______________ ______________________________________, Appellant, vs. ______________________________________, Respondent. CIVIL RESPONSE STATEMENT FOR PARTIES WITHOUT ATTORNEYS INSTRUCTIONS : Respondent must complete and file this Response Statement by the due date. The due date is 30 days after the Nevada Supreme Court issues an orde r directing the response. If you fail to file this form by the due date, the Nevada Supreme Court may decide your appeal without reviewing your response statement. Write only in the space allowed on the form. Additional pages and attachments are not permitted. The Nevada Supreme Court prefers short and direct statements. Citation to legal authority or the district court record is not required but would be helpful to the Court. Any form you file with the Nevada Supreme Court must be mailed or delivered to all other parties to this appeal or to the parties attorneys. You may file this form in person or by mail. You must file the original and 2 copies with the Clerk of the Nevada Supr eme Court. If you want the clerk to return a file-stamped copy of your form, you must submit the original and 3 copies and include a self-addressed, stamped envelope. Documents cannot be faxed or e-mailed to the Clerks Office. This form must be filed with the Clerk of the Neva da Supreme Court at the following address: Clerk of the Court Supreme Court of Nevada 201 South Carson Street Carson City, Nevada 89701 Telephone: (775) 684-1600 or (702) 486-9300 Form D 6/10/05 1 American LegalNet, Inc. www.USCourtForms.com>>>> 2Transcripts. Do you believe this court needs transcripts of any trial or hearing held in the district court? Yes No If you answered YES to this question, complete the Civil Proper Person Transcript Request Form that was sent to you. You must pay in advance for any transcripts, unless you have been granted in forma pauperis status. For further information, re fer to the instructions on the Transcript Request Form. Settlement Conference. Would you be interested in participating in a mediated settlement discussion, in which you and your opponent discuss settling your dispute with the assistance of a trained mediator? Yes No NOTE: If the court determines that this case may be suitable for a settlement conference, then you will be contacted. Statement of Facts. Is the statement of facts in appellants statement or brief correct? If not, please explain. (Your answer must be provided in the space allowed.) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Form D 6/10/05 2 American LegalNet, Inc. www.USCourtForms.com>>>> 3________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Form D 6/10/05 3 American LegalNet, Inc. www.USCourtForms.com>>>> 4District Court Decision. Explain why the district courts decision was correct, and should be upheld by this court (Your answer must be provided in the space allowed). ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ______________________________________________________