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UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT CRIMINAL APPEAL INFORMATION STATEMENT PART I - Please type. Attach additional pages if necessary. SHORT CAPTION WITH IDENTITY OF APPELLANT - APPEAL FROM DISTRICT COURT U.S.C.A. Caption: ______________________________________________________________ U.S.C.A. No.: District: D.C. Docket No.: Date Judgment: ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ Filed Date in D.C.: ______________________________________________________________ Date NOA filed: ______________________________________________________________ Is this a Cross-Appeal? Yes No No Was there a previous appeal in case? Yes If yes, Short Title: ______________________________________________________________ Appeal Docket No.: ______________________________________________________________ Citation, if reported: ______________________________________________________________ State any other related proceedings in this Court or District Court. American LegalNet, Inc. www.FormsWorkFlow.com PART II Please indicate basis of appeal: NOTE: This statement will assist the Court in case management. It is not intended to preclude presentation of issues on appeal. Bail (appeal from order granting, denying, modifying terms and conditions of bail on release on bond pending appeal) Judgment of Conviction/Commitment. (A) Sentence (B) Conviction (C ) Both Appeal will challenge only the merits of the underlying conviction. Appeal will challenge both the merits of the underlying conviction and the validity of the sentence imposed. Appeal will challenge only the validity of the sentence imposed. This is to certify that a copy of this criminal appeal information statement was served on each party or their counsel of record this day of , 20 . ______________________________________________________________________________ Signature of Counsel for Appellant ______________________________________________________________________________ Name ___________________________________________________________________________________ Address, City, State & Zip Code ( )_________________________ Area Code & Telephone No. American LegalNet, Inc. www.FormsWorkFlow.com U.S. COURT OF APPEALS FOR THE THIRD CIRCUIT NOTICE TO COUNSEL CONCERNING PROCEDURES FOR APPEALS FROM CRIMINAL CONVICTIONS Pursuant to 18 U.S.C. § 3742, an appeal may challenge the conviction, or sentence or both the conviction and sentence. A single Notice of Appeal will be sufficient to raise issues pertaining to both merits and sentencing. The Court disfavors bifurcation of the issues relating to the sentence from those relating to the merits of the conviction. If the appeal is from a criminal conviction in which the sentence of confinement is one (1) year or less and the appellant is not released on bail pending appeal, a motion to expedite the appeal may be filed in accordance with 3rd Cir. 4.1. A response to any such motion to expedite must be received in the Court of Appeals within seven (7) days of service of the motion. Criminal appeals will be governed by the Court's current rules and procedures. The appellant in all cases in which a criminal sentence is challenged is responsible for submitting four (4) copies of the presentence report in a sealed envelope at the time the appendix is due to be filed. LAR 30.3(c). This impounded document should not be included in the appendix which is normally not filed under seal. In all direct criminal cases trial counsel, whether retained or appointed, will be required to continue on appeal until relieved by order of this Court. 3rd Cir. LAR Misc. 109.1. If counsel is not a member of this Court's bar, counsel is required to apply for admission promptly. 3rd Cir. LAR 46.1 and Misc. 109.1. The Criminal Appeal Information Statement must be filed. Parts I and II of form including the certificate of service at the end of Part II must be completed and filed at the time the Notice of Appeal is filed. Questions concerning appeals procedures should be directed to Third Circuit Clerk's office at 215-597-2995. American LegalNet, Inc. www.FormsWorkFlow.com