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800 - 00006 - Docketing Statement ( 01/2018 ) Page 1 of Vermont Supreme Court 109 State Street Montpelier , VT 05 609 - 0801 802 - 828 - 4774 www.vermontjudiciary.org DOCKETING STATEMENT Vermont Rule of Appellate Procedure (V.R.A.P.) 3(e) Supreme Court Docket No. (if known) : Case Name: Filed by or on behalf of : (party name) Choose One: Appellant Appellee Appellee need not complete Sections A or B unless A A. Original Court /Board I nformation 1. Court/Board Name : 2. Court/Board Docket No.: 3. Judge Name (if applicable) : 4. Date of Decision Being Appealed : 5. Date Notice of Appeal Filed : B. Brief Description of Case . (Separate sheet may be attached) C. Statement of Issues t o b e Raised on Appeal . (Separate sheet may be attached) D. Is the decision being appealed a written order ? Yes No ( If yes, please attach ) American LegalNet, Inc. www.FormsWorkFlow.com 800 - 00006 - Docketing Statement ( 01/2018 ) Page 2 of E. Transcripts Are t ranscripts necessary for the appeal? Yes No If yes, have you ordered transcripts? Yes No If ordered, attach a copy of the receipt from the transcription company. If you have already ordered and received transcripts that you want to include in the record on appeal, you must list those hearing dates below and arrange to have the transcription service transmit the transcript to the Court. For Appelle e Only : Do you agree as to which transcript(s ) are necessary for the appeal? Yes No If not, see V.R.A.P. 10(b)(5). F. Expedited Resolution Is this matter appropriate for expedited disposition by a three - Justice panel? Yes No See criteria in V.R.A.P. 33. 2 (b) . Please Explain. (Separate sheet may be attached) Signature: Date: Name : Mailing a ddress : P hone : Email address : Attorney for : American LegalNet, Inc. www.FormsWorkFlow.com