Appellate Docket Number: ___________________________________________ Appellate Case Style: ________________________________________________ DOCKETING STATEMENT (CRIMINAL) Tenth Court of Appeals McLennan County Courthouse 501 Washington Ave., Rm 415 Waco, Texas 76701-1327 (254) 757-5200 [to be filed in the court of appeals upon perfection of appeal under TRAP 32] I. Parties (TRAP 32.2(a)): Appellant (or Appellee, if State is appealing): Co-defendant(s): (See note at bottom of page) (See note at bottom of page) Trial Attorney: Appellate Attorney: Appointed □ Retained □ Appointed □ Retained □ If appointed, was a hearing on indegency held? Yes □ No Address: Address: Telephone Number: (include area code) Fax Number: (include area code) Email: Telephone Number: (include area code) Fax Number: (include area code) Email: SBN (lead counsel): □ SBN (lead counsel): If not represented by counsel, provide appellant’s (appellee’s, if State is appealing) address, telephone number, and fax number. -1American LegalNet, Inc. www.USCourtForms.com II. Perfection Of Appeal, Judgment And Sentencing (TRAP 25.2, 32.2(b), (d), (f), (g), (h), (i), (j), (k)): Date trial court imposed or suspended sentence in open court or date trial court entered appealable order: Was a certificate of Defendant’s Right of Appeal signed by the trial court? Yes (Attach a copy showing signature, if possible) Date notice of appeal filed in trial court: (Attach file-stamped copy; if mailed to the trial court clerk, also give the date of mailing) □ No □ (Attach a file-stamped copy of the certification) Was the Certification of Defendant’s Right of Appeal in the record at the time the notice of appeal was filed? Yes □ No □ Does the Certification of Defendant’s Right of Appeal show a right to appeal? Yes □ No □ Offense charged: Punishment assessed: Date of offense: Is the appeal from a pretrial order? Yes Defendant’s plea: □ No □ If yes, please specify: If guilty, does Defendant have the trial court’s permission to appeal? Does the appeal involve the validity of a statute, rule or ordinance? Yes □ No □ If yes, please specify: Was the trial jury or nonjury? Guilt or innocence phase: Jury □ Nonjury □ Nonjury Will you challenge this Court’s jurisdiction? If yes, explain. □ Punishment phase: Jury □ -2American LegalNet, Inc. www.USCourtForms.com III. Actions Extending Time To Perfect Appeal (TRAP 32.2(e)): Filed Action Check as appropriate Motion for New Trial No □ Yes □ Motion in Arrest of Judgment No Other (specify): No □ □ Yes Yes Date Filed □ □ IV. Indigency Of Party (TRAP 32.2(n)): (Attach file-stamped copy of motion and affidavit) Filed Event Check as appropriate Date Motion and affidavit filed No □ Yes □ Date of hearing: No □ Yes N/A □ Date of order: Ruling on motion: Granted □ V. Court: Trial Court And Record (TRAP 32.2(c), (l), (m)): County: Denied □ Trial Court Docket Number (Cause No.): Trial Judge (who tried or disposed of case): District/County Clerk: Telephone Number: (include area code) Telephone Number: (include area code) Fax Number: (include area code) Fax Number: (include area code) Address: Address: Clerk’s Record Yes □ Will request □ (Note: No request required under TRAP 34.5(a), (b)) Clerk’s fee has been paid or satisfactory arrangements have been made: Yes □ No □ Was requested on: If no, explain: -3American LegalNet, Inc. www.USCourtForms.com All court reporters/records who recorded any portion of the record must be listed: Court Reporter/ Recorder: Court Reporter/Recorder: Telephone Number: (include area code) Telephone Number: (include area code) Fax Number: (include area code) Fax Number: (include area code) Address: Address: (Attach additional sheet if necessary for additional court reporters/recorders) Length of trial (approximate): Reporter’s fee has been paid or satisfactory arrangements have been made: Yes □ No □ If no, explain: Reporter’s or Recorder’s Record None □ Will request □ Was requested on: (check if electronic recording □) VI. Related Matters: List any pending or past related appeals before this or any other Texas appellate court by court, docket number, and style. VII. Other Information: Please give any other information helpful to process this appeal (see attachments, if any). VIII. Signature: __________________________________________________ Signature of counsel (or pro se party) Date: _________________________ State Bar No.:___________________ Printed Name: _____________________________________ IX. Certificate of Service: The undersigned counsel certifies that this docketing statement has been served on the following lead counsel for all parties to the trial court’s order or judgment as follows on ______________________, 20____. ________________________________________ Signature (TRAP 9.5(e) requirements stated below; use additional sheets, if necessary) Note: Certificate of Service Requirements (TRAP 9.5(e)): A certificate of service must be signed by the person who made the service and must state: (1) the date and manner of service; (2) the name and address of each person served; and (3) if the person served is a party’s attorney, the name of the party represented by that attorney. -4American LegalNet, Inc. www.USCourtForms.com