Appellate Docket Number: ___________________________________________ Appellate Case Style: DOCKETING STATEMENT (CRIMINAL) Court of Appeals [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) Trial Attorney: Appellate Attorney: Appointed ¨ Appointed ¨ Retained ¨ Retained ¨ If appointed, was a hearing on indigency held? Yes ¨ No ¨ Address: Address: Telephone: (include area code) Telephone: (include area code) Telecopy: (include area code) Telecopy: (include area code) SBN: SBN: If not represented by counsel, provide appellant’s (appellee’s, if State is appealing) address, telephone number, and telecopy number. HOU05:76691.1 American LegalNet, Inc. www.USCourtForms.com II. Perfection Of Appeal, Judgment And Sentencing (TRAP 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: Date notice of appeal filed in trial court: (Attach a signed copy, if possible) (Attach file-stamped copy; if mailed to the trial court clerk, also give the date of mailing) Offense charged: Punishment assessed: Is the appeal from a pretrial order? Yes ¨ Date of offense: No ¨ If yes, please specify. Defendant’s plea: Does the appeal involve the validity of a statute, rule or ordinance? Yes ¨ No ¨ If guilty, does Defendant have the trial court’s permission to appeal? If yes, please specify. Yes ¨ No ¨ Was the trial jury or nonjury? Will you challenge this Court’s jurisdiction? If yes, explain. Guilt or innocence phase: Jury ¨ Nonjury ¨ Punishment phase: Jury ¨ III. Nonjury ¨ Actions Extending Time To Perfect Appeal (TRAP 32.2(e)): Action Filed Check as appropriate Motion for New Trial No ¨ Yes ¨ Motion in Arrest of Judgment No ¨ Date Filed Yes ¨ HOU05:76691.1 American LegalNet, Inc. www.USCourtForms.com No ¨ Other (specify): IV. Yes ¨ Indigency Of Party (TRAP 32.2(n)): (Attach file-stamped copy of motion and affidavit) Filed Check as appropriate Event No ¨ Motion and affidavit filed Date N/A Yes ¨ Date of hearing: Date of order: Ruling on motion: Granted ¨ Denied ¨ V. Trial Court And Record (TRAP 32.2(c), (l), (m)): Court: County: Trial Court Docket Number (Cause No.): Trial Judge (who tried or disposed of case): Court Clerk (district clerk): Telephone Number: (include area code) Telephone Number: (include area code) Telecopy Number: (include area code) Address: Telecopy Number: (include area code) Address: Clerk’s Record Will request ¨ Was requested on: (Note: No request required under TRAP 34.5(a), (b)) HOU05:76691.1 −3− American LegalNet, Inc. www.USCourtForms.com Yes ¨ Court Reporter or Court Recorder: Court Reporter or Court Recorder: Telephone Number: (include area code) Telephone Number: (include area code) Telecopy Number: (include area code) Telecopy Number: (include area code) Address: Address: (Attach additional sheet if necessary for additional court reporters/recorders) Length of trial (approximate): Reporter’s or Recorder’s Record (check if electronic recording ¨) State arrangements made for payment of court reporter/recorder: None ¨ Will request ¨ Was requested on: 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. Any other information requested by the court (see attachments, if any). HOU05:76691.1 −4− American LegalNet, Inc. www.USCourtForms.com 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 ______________________, 19____. ________________________________________ 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) (2) (3) HOU05:76691.1 the date and manner of service; the name and address of each person served; and if the person served is a party’s attorney, the name of the party represented by that attorney. −5− American LegalNet, Inc. www.USCourtForms.com HOU05:76691.1 −6− American LegalNet, Inc. www.USCourtForms.com