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In the Appellate Court of Illinois, First District Docket Number ) ) ) ) ) ) ) ) ) Case Title (Complete) Appeal from Circuit Number Trial Judge Date of Notice of Appeal Date of Judgement Date of Post-Judgement Motion Order County DOCKETING STATEMENT (Civil) 1. Is this a cross-appeal, separate appeal, joining in a prior appeal, or related to another appeal which is currently pending or which has been disposed of by this court? If so, state the docket number(s) of the other appeal(s): 2. Is any party is a corporation or association, identify any affiliate, subsidiary, or parent group: 3. Full name of appellant(s) filing this statement: Counsel on Appeal For appellant(s) filing this statement Name: Address: Telephone: Fax: Trial counsel if different Name: Address: Telephone: Fax: 1 American LegalNet, Inc. www.FormsWorkFlow.com 4. Counsel on Appeal For Appellee(s) (if there are multiple appellees represented by different counsel, identify separately) Name: Address: Telephone: Fax: Trial counsel if different Name: Address: Telephone: Court Reporter(s) (if more space is needed, use other side) Name: Address: Telephone: Approximate Duration of trial court proceedings to be transcribed Can this appeal be accelerated? 6. Briefly state the supreme court rule, or the law, which confers jurisdiction upon the reviewing court; the facts of the case which bring it within this rule or other law; and the date that the order being appealed was entered and any other facts which are necessary to demonstrate that the appeal is timely: 7. Nature of Case: Administrative Review Contract Estates Personal Injury Tort Juvenile Domestic Relations Child Custody or Support Product Liability Forcible Detainer Other 2 American LegalNet, Inc. www.FormsWorkFlow.com 8. Briefly describe the nature of the case and the result in the trial court, and set forth any reasons for an expedited schedule: 9. State the general issues proposed to be raised (failure to include an issue in this statement will not result in the waiver of the issue on appeal): I, as attorney for the appellant, hereby certify that on (DATE) INDICATE WHICH: and on (DATE) prepare the transcript(s). I made a written request to the court reporter(s) to I DATE APPELLANT'S ATTORNEY In lieu of a reporter's signature I have attached the written request to the court reporter(s) to prepare the transcript(s). DATE APPELLANT'S ATTORNEY I hereby acknowledge receipt of an order for the preparation of a report of proceedings. DATE COURT REPORTER OR SUPERVISOR STEVEN M. RAVID, CLERK OF APPELLATE COURT FIRST DISTRICT 3 American LegalNet, Inc. www.FormsWorkFlow.com