Free FORM (CRIMINAL) - Illinois

FORM (CRIMINAL) DOCKETING STATEMENT Case Title: (Complete) Appeal from County Circuit Court No. Date of Notice of Appeal Trial Judge ( ) Felony ( ) Misdemeanor ( ) In custody ( ) Out on Bond

VS.

Counsel on Appeal for Appellant(s): Name: Address: City, State, Zip: Telephone: Counsel on Appeal for Appellee(s): Name: Address: City, State, Zip: Telephone:

Trial Counsel, if different Name: Address: City, State, Zip: Telephone: Trial Counsel, if different Name: Address: City, State, Zip: Telephone:

Court Reporter(s): (If more space is needed, use other side) Name: Name: Address: Address: City, State, Zip: City, State, Zip: Telephone: Telephone: Approximate duration of trial court proceedings to be transcribed: Nature of Case: ( ) Appeal from Conviction ( ) Sentence only ( ) Revocation of Probation after trial ( ) Jury Trial ( ) Bench Trial ( ) Appeal by State ( ) Plea of guilty ( ) Post-conviction proceedings General statement of issues proposed to be raised. (Failure to include an issue in this statement will not result in the waiver of the issue on appeal).

I, as attorney for the Appellant, HEREBY CERTIFY, that on The Clerk of the Circuit to prepare the record, and on A written request to the Court Reporter(s) to prepare the transcript. Date

I asked I made

Attorney for Appellant(s) I hereby acknowledge receipt of an order for the preparation of a report of proceedings. Date:

(Court reporter of Supervisor) Please attach proof of service.