Free County Court District Court ___________________________ County, Colorado Court A... - Colorado

County Court District Court ___________________________ County, Colorado Court Address: State of Colorado/Appellee: v. Defendant/Appellant: Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number:

Phone Number: FAX Number:

E-mail: Division Courtroom Atty. Reg. #: NOTICE OF APPEAL AND DESIGNATION OF RECORD - CRIMINAL

The Defendant hereby files an appeal in _______________________ (County Court case number) for the following reason(s): __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ At this time, I request a stay of execution. I understand that as a condition of the stay of execution, I may be required to post a bond or deposit the amount of fines and costs assessed. Current information about the Appellant/Defendant: Full Name: ______________________________________________________________________________ Mailing Address: __________________________________________________________________________ City & Zip: _______________________________________________________________________________ Home Phone #: ____________________ Work Phone #: ___________________ Cell #: _________________ Designation of Record: The clerk of court will prepare the record on appeal, pursuant to Rule 37, Rules of Criminal Procedure and will include the following items: The county court case file, including all pleadings, motions, reports, exhibits, orders of the court, and jury instructions, if applicable. The original transcript: (identify proceedings). _____________________________________________________________________________ ________________________________________________________________________________ Date: _____________________________________ ________________________________________
Signature of Defendant/Appellant

_________________________________________
Signature of Attorney for Defendant/Appellant, if applicable

CERTIFICATE OF SERVICE
I certify that on _______________________ (date) an original was filed with the Court and that a true and accurate copy of this NOTICE OF APPEAL/DESIGNATION OF RECORD - CRIMINAL was provided to other party by: Hand Delivery or Faxed to this number ____________________ or by placing it in the United States mail, postage pre-paid, and addressed to the following: To: ___________________________________ ___________________________________ ___________________________________
(Your signature) JDF 222 2/05 NOTICE OF APPEAL AND DESIGNATION OF RECORD - CRIMINAL