Free NOTICE OF APPEAL - Utah

______________________________ Name ______________________________ Address (optional) ______________________________ City (optional) ______________________________ Telephone (optional) _____________________________________________________________________________ IN THE ________________DISTRICT JUVENILE COURT FOR_________________COUNTY ______________________________________________________________________________ IN THE INTEREST OF_________________, ) NOTICE OF APPEAL A MINOR. ) ) JUVENILE NO._____________________ ) ) ) Case No.________________ ______________________________________________________________________________ 1. I hereby appeal from the denial of my Petition for Waiver of Parental Consent to

Minor's Abortion issued on____________, in the _________________District Juvenile Court. 2. I am represented by an attorney as follows: Name of attorney____________________________________________ Address __________________________________________________ Telephone number___________________________________________ 3. The Juvenile Court's decision was wrong for the following reasons:

______________________________________________________________________________ ______________________________________________________________________________

3/07

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. I _____will_____not appear at any appellate oral argument_____in person_____

by telephone. My telephone number is ____________________________ DATE: ____________________

________________________________ Petitioner's signature

3/07