Free Application for Allowance of Appeal from the Small Claims and Conciliation Branch - District of Columbia

Form 3. Application for Allowance of Appeal from the Small Claims and Conciliation

DISTRICT OF COLUMBIA COURT OF APPEALS Branch of the Civil Division. _________________________________ Applicant _________________________________ _________________________________ (Address) v. No._____________________

_________________________________ Respondent _________________________________ _________________________________ (Address) APPLICATION FOR ALLOWANCE OF APPEAL FROM THE SMALL CLAIMS AND CONCILIATION BRANCH OF THE CIVIL DIVISION OF THE SUPERIOR COURT OF THE DISTRICT OF COLUMBIA 1. Applicant was the plaintiff (or) defendant in the case below and

seeks to appeal the decision (ruling) entered on the _______ day of __________ 20___, in the Small Claims Branch in case number ___________________. The case below was captioned: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 2. The decision was made by a: Judge Jury

3. The name of the trial judge. Please note that you may only seek review in this court of a final decision of a judge; if the decision was made by a magistrate judge you must first file for review by a judge in the Small Claims Division.____________________________________________________ 4. Description of case filed below (indicate the amount of judgment and why the lawsuit was filed): ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

2 5 The ruling made by the judge: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 6 State why the Court of Appeals should accept thisapplication. Specificall state how the trial y, court erred in making its decision or what important issue theapplication raises that the Court of Appeals has not yet decided but should decide. State thes points as simply and specifically e as possible and include facts and evidence necessarfor the court to consider the . Attach y m additional pages if necessar y: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

____________________________________ Applicant/Attorney (all but natural persons representing themselves must be represented by counsel) ____________________________________ ____________________________________ ____________________________________ Address ____________________________________ Telephone Number CERTIFICATE OF SERVICE I hereby certify that I have mailed a copy of this application, postage prepaid, to ___________________________________________________ this ________ day of _________________, 20____.

____________________________________ Applicant/Attorney