Free Form 6 - Hawaii

IN THE ______________________________________________ (Court or Agency From Which Appeal is Taken) CIVIL APPEAL DOCKETING STATEMENT (For Use By The Appellate Conference Program) INTERNAL USE ONLY

PLEASE TYPE OR PRINT, ATTACH ADDITIONAL PAGES IF NECESSARY. TITLE Lower Court/Agency Docket Number: Is this a Cross-Appeal? _____ Yes _____ No Has this matter previously been before the Hawai#i Appellate Courts? _____ Yes _____ No If yes, state when: Case Name: SC Docket Number: CHECK AS MANY AS APPLICABLE JURISDICTION 1.LOWER COURT/AGENCY ( ) Statutory ( ) Other Grounds (specify) 2. APPELLATE LOWER COURT/AGENCY DISPOSITION 1. STAGE OF PROCEEDINGS ( ) Pre-Trial ( ) During Trial ( ) Interlocutory Decision ( ) Other (Specify) ( ) After Trial () Dismissal/Jurisdiction ( ) Judgment/Jury Verdict ( ) Dismissal/Merits ( ) Summary Judgment ( ) Other (Specify) ( ) Judgment NOV ( ) Declaratory Judgment ( ) Directed Verdict ( ) Other (Specify) 2. TYPE OF JUDGMENT / ORDER APPEALED ( ) Default Judgment ( ) Judgment/Court Decision 3. RELIEF

( ) Final Decision of Lower Court / Agency

( ) Damages: Amount Sought: $__________ Amount Granted: $__________ ( ) Injunctions ( ) Preliminary ( )Permanent ( ) Granted ( ) Denied

BRIEF DESCRIPTION OF NATURE OF ACTION AND RESULT BELOW:

ANTICIPATED ISSUES PROPOSED TO BE RAISED ON APPEAL:

MAY THE MEDIATOR CONTACT THE TRIAL JUDGE TO DISCUSS THE CASE? _____ Yes _____ No

Page 2

BASED ON YOUR PRESENT KNOWLEDGE: 1. Does this appeal involve a question of first impression or present a novel legal question? _____ Yes _____ No 2. Does this appeal involve a question of state or federal constitutional interpretation? _____ Yes _____ No 3. Does this case raise a question of law regarding the validity of a state statute, county ordinance, or agency regulation? _____ Yes _____ No 4. Does this case involve issues upon which there is an inconsistency in the decisions of the Intermediate Court of Appeals or the Supreme Court? _____ Yes _____ No 5. Will the determination of this appeal turn on the interpretation or application of particular case or statute? _____ Yes _____ No Case name/statute: Citation: Docket Number, if unreported: If Yes, provide:

DOES THIS APPEAL INVOLVE ANY OF THE FOLLOWING: _____ Likelihood of a motion to expedite the appeal. _____ Multiple parties on either side for whom joint briefing is possible. _____ Likelihood of motions to intervene on appeal. _____ Likelihood of motions to file amicus briefs. _____ Likelihood of motions to stay appeal pending resolution of a related case. Identify case name, docket number, and court or agency: _____ Other procedural complexities. If so, please identify them:

COUNSEL FOR APPELLANTS: NAME: ADDRESS: TELEPHONE ( EMAIL: )

TRIAL COUNSEL FOR APPELLANT(S) (If different from appeal counsel) NAME: ADDRESS: TELEPHONE ( EMAIL: )

Page 3

I CERTIFY THAT A COPY OF THIS CIVIL APPEAL DOCKETING STATEMENT WAS SUBMITTED TO THE CLERK OF THE LOWER COURT/AGENCY AND THAT IT WAS SERVED ON EACH PARTY/COUNSEL SHOWN ON THE ATTACHED SERVICE LIST.

Signature

Date

REMEMBER TO ATTACH COPIES OF (1) THE ORDER/JUDGMENT APPEALED FROM, (2) ANY WRITTEN OPINION OR FINDINGS OF FACT AND CONCLUSIONS OF LAW SUPPORTING THE ORDER/JUDGMENT, AND (3) PROOF OF SERVICE ON ALL OTHER PARTIES TO THE PROCEEDINGS BELOW (WITH TELEPHONE NUMBERS)

Page 4