DOCKETING STATEMENT FOR A CRIMINAL APPEAL R evised 4-3-09vb This docketing statement must be filed by all appellants with the Clerk of the Fourth Court of Appeals, 300 Dolorosa, Suite 3200, San Antonio, TX 78205, upon perfecting appeal. See TEX . R. APP . P. 32.2. Appeal No. ________________________________________ (To be assigned by the Clerk of the Fourth Court of Appeals.) Case Style Below _______________________________________________________________________________ v. _______________________________________________________________________________ Trial Court No. _______________________ Court No. & County __________________________________________ APPELLANT(S) Name of appellant(s)* _______________________________________________________________________________ Name of lead counsel (if represented) ___________________________________________________________________ Law firm (if attorney) _______________________________________________________________________________ Address __________________________________________________________________________________________ Phone ( ) _______________________ Fax ( ) _______________________ SBN _____________________________ Whether counsel is appointed or retained ________________________________________________________________ Are any related cases or cases raising related issues pending in this court or the trial court, i.e., co-defendant or same issue involving another defendant? Q YES Q NO If yes, cite the case and the manner in which it is related on a separate page. If abeyance, consolidation, or joint oral argument is warranted, counsel must file a separate motion seeking such relief. NOTICE OF APPEAL Date filed in the trial court__________________ Date mailed to the trial court clerk, if applicable ___________________ TRIAL COURT Name of judge who tried the case and signed the judgment or appealable order __________________________________ Date judgment/appealable order signed ____________ Date sentence imposed/suspended in open court ______________ Filing date for motion for new trial, arrest of judgment, or other filing that affects the time for perfecting appeal ____________________________________________________ Offense(s) charged ______________________________________ Date of offense ______________________________ Defendant’s plea: Q Guilty Q Not Guilty Q Nolo contendere Trial: Q Jury Q Non-jury Punishment assessed ________________________________________________________________________________ Is this appeal from a pre-trial order? Q YES Q NO If yes, identify order _________________________________ Does this appeal involve the validity of a statute, ordinance, or rule? QYES Q NO If yes, identify ________________ REPORTER’S RECORD Date requested: __________________________________________________ Electronically recorded? Q YES Q NO Length of trial or hearing in days: ______________________________________________________________________ Will there be an agreed record or an agreed statement of the case? Q YES Q NO Court reporter’s name: _______________________________________________________________________________ a. Q OFFICIAL or Q SUBSTITUTE b. Address and phone no.: __________________________________________________________________ c. If substitute, name of official court reporter for trial court: ______________________________________ American LegalNet, Inc. www.FormsWorkflow.com AFFIDAVIT OF INDIGENCE Date filed: ________________________________ Date contest filed, if any: ___________________________________ Date of order on contest, if any: ___________________________ Q SUSTAINED Q OVERRULED Q NO RULING CERTIFICATE OF SERVICE As attorney of record (or appellant pro se), I hereby certify that a copy of this docket sheet has been served by first class mail or by fax, prior to filing, to all other parties to the judgment or order being appealed. Date _________________ Attorney of Record (signature) ________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com