In the District Court of ____________ County, Kansas
_______________________ Plaintiff vs. _______________________ Defendant NOTICE OF APPEAL
TAKE NOTICE THAT the appellant, _______________________________, herein appeals to the District Court of ______________ County, Kansas from the Judgment of the District (Magistrate) Court, judgment in small claims. ________________________________ Appellant ******************************************************************************
Case Number_____________
REQUEST FOR TRIAL BY JURY
APPELLANT does ____ does not ____ request that hearing on his appeal herein be set to a jury of ____ members. _________________________________ Appellant Dated this ____ day of ___________________, _____.