Petition For Appeal Of Jury Verdict {SCA-M110}

W.Va. Code 50-5-12, 13 SCA-M110-1P 1/06 Docket Code(s): MGPAV IN THE MAGISTRATE COURT COUNTY, WEST VIRGINIA Magistrate Court Case No. Circuit Court Appeal No. Name, Address & Phone Number of Plaintiff: v. Name, Address & Phone Number of Defendant PETITION FOR APPEAL OF JURY VERDICT The Appellant, , pursuant to West Virginia Code 24750 - 5 - 12 or 24750 - 5 - 13, hereby files this petition for appeal with the Circuit Court. This appeal is from an order entered by Magistrate , of County Magistrate Court on 20 . Appellant The issues to be presented on appeal are (state briefly each ground on which you claim that the Magistrate Court erred in judgment): A. Ground one: Supporting FACTS: B. Ground two: Supporting FACTS: American LegalNet, Inc. www.FormsWorkFlow.com W.Va. Code 50-5-12, 13 SCA-M110-2P 1/06 Docket Code(s): MGPAV C. Ground three: Supporting FACTS: D. Ground four (additional sheets may be attached): Supporting FACTS: The following items are to be included in the record on appeal: 1. Pleadings. The Appellant designates the following pleadings (examples include Complaint, Answer, Motions): 2. Transcript. The Appellant designates the following portions of testimony: 3. Exhibits. The Appellant designates the following exhibits: Appellant CERTIFICATE OF SERVICE I, , hereby certify that I have served a copy of the above petition for appeal on the attorneys for all parties, or if such parties are not represented by attorneys, to the parties themselves on the day of . by hand by first - class mail to: Signature Date Name and address of attorneys or parties served: American LegalNet, Inc. www.FormsWorkFlow.com