Official Federal Forms > Circuit Court Of Appeals > 11th Circuit Court Of Appeals
Civil Appeal Statement - Official Federal Forms
| Civil Appeal Statement Form. This is a national form and can be used in 11th Circuit Court Of Appeals Circuit Court Of Appeals . |
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File Stamp Rev. 2/11 UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT CIVIL APPEAL STATEMENT Please TYPE. Attach additional pages if necessary. 11th Circuit Docket Number: _________________________________ District and Division: Name of Judge: Nature of Suit: Date Complaint Filed: District Court Docket Number: Date Notice of Appeal Filed: Cross Appeal Class Action Has this matter previously been before this court? Yes No If Yes, provide (a) Caption: (b) Citation: (c) Docket Number: Caption: Attorney Name For Appellant: Plaintiff Defendant Other (Specify) Mailing Address Telephone, Fax, and Email For Appellee: Plaintiff Defendant Other (Specify) Please CIRCLE/CHECK/COMPLETE the items below and on page 2 that apply. Jurisdiction Federal Question Diversity US Plaintiff US Defendant Nature of Judgment Final Judgment, 28 USC 1291 Interlocutory Order, 28 USC 1292(a)(1) Interlocutory Order Certified, 28 USC 1292(b) Interlocutory Order, Qualified Immunity Final Agency Action (Review) 54(b) Type of Order Dismissal/Jurisdiction Default Judgment Summary Judgment Judgment/Bench Trial Judgment/Jury Verdict Judgment/Directed Verdict/NOV Injunction Other ________________________ Relief Amount Sought by Plaintiff: $_______________________ Amount Sought by Defendant: $_______________________ Awarded: $_______________________ to ______________________ Injunctions: TRO Preliminary Permanent Granted Denied American LegalNet, Inc. www.FormsWorkFlow.com Page 2 11th Circuit Docket Number: ____________________________ Based on your present knowledge: (1) Does this appeal involve a question of First Impression? What is the issue you claim is one of First Impression? Yes No Yes No (2) Will the determination of this appeal turn on the interpretation or application of a particular case or statute? If Yes, provide (a) Case Name/Statute (b) Citation (c) Docket Number if unreported (3) Is there any case now pending or about to be brought before this court or any other court or administrative agency that (a) Arises from substantially the same case or controversy as this appeal? Yes No (b) Involves an issue that is substantially the same, similar, or related to an issue in this appeal? Yes No If Yes, provide (a) Case Name (b) Citation (c) Docket Number if unreported (d) Court or Agency (4) Will this appeal involve a conflict of law (a) Within the Eleventh Circuit? Yes (b) Among circuits? Yes No If Yes, explain briefly: No (5) Issues proposed to be raised on appeal, including jurisdictional challenges: I CERTIFY THAT I SERVED THIS CIVIL APPEAL STATEMENT ON THE CLERK OF THE U.S. COURT OF APPEALS FOR THE ELEVENTH CIRCUIT AND SERVED A COPY ON EACH PARTY OR THEIR COUNSEL OF RECORD, THIS ____________ DAY OF ___________________________, ____________. _______________________________________________________ NAME OF COUNSEL (Print) _______________________________________________________ SIGNATURE OF COUNSEL Please ATTACH portion of district court, tax court, or agency record described in 11th Cir. R. 33 1(b): (a) judgments and orders appealed from or sought to be reviewed; (b) any supporting opinion, findings of fact, and conclusions of law filed by the court or the agency, board, commission, or officer; (c) any report and recommendation adopted by an order; (d) findings and conclusions of an administrative law judge when appealing a court order reviewing an agency determination; (e) any agency docket sheet or record index. American LegalNet, Inc. www.FormsWorkFlow.com
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