Free Civil Appeals - Washington

A-11 (rev. 7/00)

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USCA DOCKET # (IF KNOWN)

UNITED STATES COURT OF APPEALS FO R TH E NINTH CIRCUIT CIVIL APPEALS DOCKETING STATEMENT
PLEASE ATTACH ADDITIONAL PAGES IF NECESSARY. TITLE IN FULL: DISTRICT: DISTRICT COURT NUM BER: DATE N OTICE OF AP PEAL FILE D: JUDGE:

IS THIS A CROSS-APPEAL?

9 YES

IF THIS MATTER HAS BEEN BEFORE THIS COURT PREVIOUSLY, PLEA SE PR OV IDE TH E D OC KE T N UM BE R AND CIT AT ION (IF ANY ):

B RIE F D ES CR IP TIO N OF NA TU RE OF AC TIO N AN D R ES UL T B EL OW :

PRINCIPAL ISSUES PROPO SED TO BE RAISED ON A PPEAL:

PLEASE IDENTIFY ANY OTHER LEGAL PROCEEDING THAT MAY HAVE A BEARING ON THIS CASE (INCLUDE PEN DING DISTR ICT C OU RT P OST JUD GM ENT M OT ION S):

9 9 9 9

DOES THIS APPEAL INVOLVE ANY OF THE FOLLOWING:

Possibility of settlement Likelihood that intervening precedent will control outcome of appeal Likelihood of a motion to expedite or to stay the appeal, or other procedural matters (Specify) Any other information relevant to the inclusion of this case in the Mediation Program

9
Possibility parties would stipulate to binding award by Appellate Commissioner in lieu of submission to judges LOWER COURT INFORMATION

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JURISDICTION FEDERAL APPELLATE DISTRICT COURT DISPOSITION TYPE OF JUDGMENT/ORDER APPEALED RELIEF

9 9 9

FEDERAL QUESTION

9 9 9

FINAL DECISION OF DISTRICT COURT

DIVERSITY

OTHER (SPECIFY):

INTERLOCUTORY DECISION APPEALABLE AS OF RIGHT

INTERLOCUTORY ORDER CERTIFIED BY DISTRICT JUDGE (SPECIFY):

9

OTHER (SPECIFY):

9 9 9 9 9 9 9 9 9

DEFAULT JUDGMENT DISMISSAL/JURISDICTION DISMISSAL/MERITS SUMMARY JUDGMENT JUDGMENT/COURT DECISION JUDGMENT/JURY VERDICT DECLARATORY JUDGMENT JUDGMENT AS A MATTER OF LAW OTHER (SPECIFY):

9 9 9 9 9 9 9 9 9

DAMAGES: SOUGHT $ AWARDED $ INJUNCTIONS: PRELIMINARY PERMANENT GRANTED DENIED

ATTORNEY FEES: SOUGHT $ AWARDED $ PENDING COSTS: $

CERTIFICATION OF COUNSEL
I CERTIFY THAT: 1. COPIES OF ORDER/JUDGMENT APPEALED FROM ARE ATTACHED. 2. A CURRENT SERVICE LIST OR REPRESENTATION STATEMENT WITH TELEPHONE AND FAX NUMBERS IS ATTACHED (SEE 9TH CIR. RULE 3-2). A COPY OF THIS CIVIL APPEALS DOCKETING STATEMENT WAS SERVED IN COMPLIANCE WITH FRAP 25. I UNDERSTAND THAT FAILURE TO COMPLY WITH THESE FILING REQUIREMENTS MAY RESULT IN SANCTIONS, INCLUDING DISMISSAL OF THIS APPEAL.

3. 4.

Signature

Date

COUNSEL WHO COMPLETED THIS FORM
NAME: FIRM: ADDRESS: E-MAIL: TELEPHONE: FAX:

xTHIS DOCUMENT SHOULD BE FILED IN THE DISTRICT COURT WITH THE NOTICE OF APPEALx xIF FILED LATE, IT SHOULD BE FILED DIRECTLY WITH THE U.S. COURT OF APPEALSx