IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF TEXAS Dallas DIVISION § § § NDTX Case No.: § § 5TH Circuit Appeals Court Case No.: § § § Plaintiff/Petitioner v. Defendant/Respondent NOTICE OF TRANSFER OF THE 5TH CIRCUIT RECORD ON APPEAL I hereby: acknowledge receipt of the record on appeal which consists of: volumes of transcripts volumes of the record containers of exhibits folders of state court records sealed documents other: acknowledge that the record on appeal has been transferred to the: Appellee* Appeals Court *If Appellee's brief is required, appellant must forward the record on appeal to appellee when appellant's brief is sent to the 5th Circuit and served on appellee. See attached page for additional information. I certify that I am proceeding pro se or that I am the designated attorney of record for the: Appellant Appellee I also certify that I have not altered the record in any way. Date Signature Printed Name Address Telephone Number This form is to be completed and filed with the Office of the District Clerk each time a party receives or forwards the appellate record in the case referenced above, including when the appellant or appellee forwards the record to the 5 th Circuit. American LegalNet, Inc. www.FormsWorkflow.com NOTICE REGARDING ORIGINAL RECORD 1. Where an appellee's brief is required, appellant must : a. b. 2. forward the record on appeal to appellee when appellant's brief is sent to the 5th Circuit and served on appellee; and complete the appropriate sections of the attached "Notice of Transfer of the 5th Circuit Record on Appeal" form and mail it to the District Court Clerk's Office . Where an appellee's brief is not required (e.g. appellant's counsel files an Anders brief asserting there is no non-frivolous issue on appeal, etc.), appellant must: a. b. 3. forward the record on appeal to the 5th Circuit Clerks' Office when appellant's brief is sent to the 5th Circuit; and complete the appropriate sections of the attached "Notice of Transfer of the 5th Circuit Record on Appeal" form and mail it to the District Court Clerk's Office . Where an appellee's brief is required, appellee must : a. forward the record on appeal to the 5th Circuit Clerks Office when appellee's brief is sent to the 5th Circuit; and b. complete the appropriate sections of the attached "Notice of Transfer of the 5th Circuit Record on Appeal" form and mail it to the District Court Clerk's Office . Note: The District Court has loaned you the record on appeal for your convenience in brief writing. When you are in possession of the record you are responsible for safeguarding and protecting the record. Negligent acts with respect to the record may subject you to sanctions. Willful mutilation, obliteration or destruction of the record may subject you to criminal penalties under 18 U.S.C. § 2071. American LegalNet, Inc. www.FormsWorkflow.com