IN THE SUPREME COURT OF THE STATE OF NEVADA INDICATE FULL CAPTION: No. ___________________________ DOCKETING STATEMENT CIVIL APPEALS GENERAL INFORMATION All appellants not in proper person must complete this docketing statement. NRAP 14(a). The purpose of the docketing statement is to assist the Supreme Court in screening jurisdiction, classifying cases for en banc, panel, or expedited treatment, compiling statistical information and identifying parties and their counsel. WARNING This statement must be completed fully, accurately and on time. NRAP 14(c). The Supreme Court may impose sanctions on counsel or appellant if it appears that the information provided is incomplete or inaccurate. Id. Failure to attach requested documents, fill out the statement completely, or to file it in a timely manner constitutes grounds for the imposition of sanctions, including a fine and/or dismissal of the appeal. This court has noted that when attorneys do not take seriously their obligations under NRAP 14to complete the docketing statement properly and conscientiously, they waste the valuable judicial resources of this court, making the imposition of sanctions appropriate. See KDI Sylvan Pools v. Workman, 107 Nev. 340, 344, 810 P.2d 1217, 1220 (1991). Please use tab dividers to separate any attached documents. American LegalNet, Inc. www.FormsWorkFlow.com 1. Judicial District________________________ Department________________________ County_________________________________ Judge______________________________ District Ct. Case No. ________________________________________________________ 2. Attorney filing this docketing statement: Attorney____________________________________ Telephone______________________ Firm _______________________________________________________________________ Address Client(s)_____________________________________________________________________ If this is a joint statement by multiple appellants, add the names and addresses of other counsel and the names of their clients on an additional sheet accompanied by a certification that they concur in the filing of this statement. 3. Attorney(s) representing respondent(s): Attorney ___________________________________________ Telephone ____________________ Firm __________________________________________________________________________ Address Client(s) ________________________________________________________________________ Attorney ___________________________________________ Telephone ____________________ Firm __________________________________________________________________________ Address Client(s) ________________________________________________________________________ (List additional counsel on separate sheet if necessary) 4. Nature of disposition below (check all that apply): Judgment after bench trial Judgment after jury verdict Summary judgment Default judgment Grant/Denial of NRCP 60(b) relief Grant/Denial of injunction Grant/Denial of declaratory relief Review of agency determination Dismissal: Lack of jurisdiction Failure to state a claim Failure to prosecute Other (specify): ______________________ Divorce decree: Original Modification Other disposition (specify):_________________ American LegalNet, Inc. www.FormsWorkFlow.com 5. Does this appeal raise issues concerning any of the following? Child custody Venue Adoption Termination of parental rights Grant/Denial of injunction or TRO Juvenile matters 6. Pending and prior proceedings in this court. List the case name and docket number of all appeals or original proceedings presently or previously pending before this court which are related to this appeal: 7. Pending and prior proceedings in other courts. List the case name, number and court of all pending and prior proceedings in other courts which are related to this appeal (e.g., bankruptcy, consolidated or bifurcated proceedings) and their dates of disposition: 8. Nature of the action. Briefly describe the nature of the action, including a list of the causes of action pleaded, and the result below: American LegalNet, Inc. www.FormsWorkFlow.com 9. Issues on appeal. State concisely the principal issue(s) in this appeal (attach separate sheets as necessary): 10. Pending proceedings in this court raising the same or similar issues. If you are aware of any proceeding presently pending before this court which raises the same or similar issues raised in this appeal, list the case name and docket number and identify the same or similar issues raised: 11. Constitutional issues. If this appeal challenges the constitutionality of a statute, and the state, any state agency, or any officer or employee thereof is not a party to this appeal, have you notified the clerk of this court and the attorney general in accordance with NRAP 44 and NRS 30.130? N/A Yes No If not, explain: American LegalNet, Inc. www.FormsWorkFlow.com 12. Other issues. Does this appeal involve any of the following issues? Reversal of well-settled Nevada precedent (on an attachment, identify the case(s)) An issue arising under the United States and/or Nevada Constitutions A substantial issue of first impression An issue of public policy An issue where en banc consideration is necessary to maintain uniformity of this court's decisions A ballot question If so, explain: 13. Trial. If this action proceeded to trial, how many days did the trial last? ___________ Was it a bench or jury trial?_____________________________ 14. Judicial disqualification. Do you intend to file a motion to disqualify or have a justice recuse him/herself from participation in this appeal? If so, which Justice? TIMELINESS OF NOTICE OF APPEAL 15. Date of entry of written judgment or order appeal from ________________________. Attach a copy. If more than one judgment or order is appealed from, attach copies of each judgment or order from which this appeal is taken. If no written judgment or order was filed in the district court, explain the basis for seeking appellate review: 16. Date written notice of entry of judgment or order served___________________________. Attach a copy, including proof of service, for each order or judgment appealed from. Was service by: Delivery Mail American LegalNet, Inc. www.FormsWorkFlow.com 17. If the time for filing the notice of appeal was tolled by a post-judgment motion (NRCP 50(b), 52(b), or 59), (a) Specify the type of motion, the date and method of service of the motion, and the date of filing. NRCP 50(b) Date served _________ By delivery or by mail Date of filing___________ NRCP 59 or by mail Date of filing___________ NRCP 52(b) Date served _________ By delivery Date served _________ By delivery or by mail Date of filing___________ Attach copies of all post-trial tolling motions. NOTE: Motions made pursuant to NRCP 60 or motions for rehearing or reconsideration do not toll the time for filing a notice of appeal. (b) Date of entry of written order resolving tolling motion _____________________________. Attach a copy. (c) Date written notice of entry of order resolving tolling motion served ____________________. Attach a copy, including proof of service. Was service by: Delivery Mail 18. Date notice of appeal filed __________________________. If more than one party has appealed from the judgment or order, list the date each notice of appeal was filed and identify by name the party filing the notice of appeal: 19. Specify statute or rule governing the time limit for filing the notice of appeal, e.g., NRAP 4(a), NRS 155.190, or other _____________________________________________. American LegalNet, Inc. www.FormsWorkFlow.com SUBSTANTIVE APPEALABILITY 20. Specify the statute or other authority granting this court jurisdiction to review the judgment or order appealed from: NRAP 3A(b)(1) NRS 155.190 (specify subsection) ___________________________ NRAP 3A(b)(2) NRS 38.205 (specify subsection) ___________________________ NRAP 3A(b)(3) NRS 703.376 Other (specify)__________________________________________________________________ Explain how each authority provides a basis for appeal from the judgment or order: COMPLETE THE FOLLOWING SECTION ONLY IF MORE THAN ONE CLAIM FOR RELIEF WAS PRESENTED IN THE ACTION (WHETHER AS A CLAIM, COUNTERCLAIM, CROSS-CLAIM, OR THIRD-PARTY CLAIM) OR IF MULTIPLE PARTIES WERE INVOLVED IN THE ACTION. Attach separate sheets as necessary. 21. List all parties involved in the action in the district court: If all parties in the district court are not parties to this appeal, explain in detail why those parties are not involved in this appeal, e.g., formally dismissed, not served, or other: 22. Give a brief description (3 to 5 words) of each party’s separate claims, counterclaims, cross-claims, or third-party claims, and the trial court’s disposition of each claim, and how each claim was resolved (i.e., order, judgment, stipulation), and the date of disposition of each claim. Attach a copy of each disposition. 23. Attach copies of the last-filed version of all complaints, counterclaims, and/or cross-claims filed in the district court. 24. Did the judgment or order appealed from adjudicate ALL the claims alleged below and the rights and liabilities of ALL the parties to the action below? Yes No American LegalNet, Inc. www.FormsWorkFlow.com 25. If you answered “No” to question 24, complete the following: (a) Specify the claims remaining pending below: (b) Specify the parties remaining below: (c) Did the district court certify the judgment or order appealed from as a final judgment pursuant to NRCP 54(b)? Yes No If “Yes”, attach a copy of the certification or order, including any notice of entry and proof of service. (d) Did the district court make an express determination, pursuant to NRCP 54(b), that there is no just reason for delay and an express direction for the entry of judgment? Yes No 26. If you answered “No” to any part of question 25, explain the basis for seeking appellate review (e.g., order is independently appealable under NRAP 3A(b)): VERIFICATION I declare under penalty of perjury that I have read this docketing statement, that the information provided in this docketing statement is true and complete to the best of my knowledge, information and belief, and that I have attached all required documents to this docketing statement. ________________________________ Name of appellant ________________________________ Name of counsel of record ________________________________ Date ________________________________ Signature of counsel record ________________________________ State and county where signed American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF SERVICE I certify that on the _________ day of ________________, ______, I served a copy of this completed docketing statement upon all counsel of record: By personally serving it upon him/her; or By mailing it by first class mail with sufficient postage prepaid to the following address(es): Dated this ________ day of _________________, ______. ________________________________ Signature American LegalNet, Inc. www.FormsWorkFlow.com