NOTICE OF APPEALStyle v. Notice Notice is given that [List name(s) of all appealing party(ies) on separatesheet if necessary] appeals the final judgment(s) of the Court of [List the circuit, criminal, [List the County] chancery or juvenile court] County filed on to the . [List the date(s) the[Name the Court of Appeals (civil), Court of final judgment(s)Criminal Appeals (criminal), or Supreme Court was filed in the(Workers222 Compensation)] trial court clerk222s office]Additional InformationType of Case [Check the most appropriate item] Civil Habeas Corpus Criminal Juvenile Post Conviction Dependent and Neglect Workers222s Compensation Other (Specifiy: ) Death Penalty Parental Termination 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: 223 Plaintiff 223 DefendantParty222s Address: Party222s Telephone: Attorney222s Name: BPR#: Attorney222s Address: Phone: * Attach an additional sheet for each additional Appellant * Appellee(s) Appellee: At trial: 223 Plaintiff 223 Defendant Appellee222s Address: Attorney222s Name: BPR#: Attorney222s Address: Phone: * Attach an additional sheet for each additional Appellee * CERTIFICATE OF SERVICE I, , certify that I have forwarded a true and exact copy ofthis Notice of Appeal by First Class, United States Mail, postage prepaid, to all parties and/ortheir 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 attorneyfor appellant][Revised: 5-22-09] American LegalNet, Inc. www.FormsWorkFlow.com