NOTICE OF APPEAL Style v. Notice Notice is given that [List name(s) of all appealing party(ies) on separate sheet if necessary] appeals the final judgment(s) of the Court of [List the circuit, criminal, chancery or juvenile court] County filed on to the [List the date(s) the final judgment(s) was filed in the trial court clerk’s office] [List the County] . [Name the Court of Appeals (civil), Court of Criminal Appeals (criminal), or Supreme Court (Workers’ Compensation)] Additional Information Type of Case [Check the most appropriate item] Civil Criminal Post Conviction Workers’s Compensation Death Penalty Parental Termination Habeas Corpus Juvenile Dependent and Neglect Other (Specifiy: ) Trial Court Number Trial Court Judge Civil Appeal Cost Bond [Check the most appropriate item] Filed in trial court with copy attached Indigent with copy of indigency order or affidavit attached Cash bond filed in trial court with copy attached American LegalNet, Inc. www.FormsWorkFlow.com Criminal Appeal Appearance Bond [Check the most appropriate item] Order appointing counsel with copy attached Appearance bond with copy attached Incarcerated pending appeal TDOC Number [Appellant is an inmate] List of Parties Appellant: At trial: “ Plaintiff “ Defendant Party’s Address:___________________________________________ Party’s Telephone: Attorney’s Name: _______________________________ BPR#: Attorney’s Address: Phone: * Attach an additional sheet for each additional Appellant * Appellee(s) At trial: “ Plaintiff “ Defendant Appellee: Appellee’s Address: Attorney’s Name: _______________________________ Attorney’s Address: BPR#: Phone: * Attach an additional sheet for each additional Appellee * CERTIFICATE OF SERVICE I, , certify that I have forwarded a true and exact copy of this Notice of Appeal by First Class, United States Mail, postage prepaid, to all parties and/or their attorneys in this case in accordance with Rule 20 of the Tennessee Rules of Appellate Procedure on this the day of , 20 . [Signature of appellant or attorney for appellant] [Revised: 5-22-09] American LegalNet, Inc. www.FormsWorkFlow.com