Free APP-004 Civil Case Information Statement (Appellate) - California


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Date: June 24, 2009
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State: California
Category: Court Forms - State
Author: Judicial Council of California
Word Count: 940 Words, 6,119 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courtinfo.ca.gov/forms/documents/app004.pdf

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TO BE FILED IN THE COURT OF APPEAL CIVIL CASE INFORMATION STATEMENT
COURT OF APPEAL, APPELLATE DISTRICT, DIVISION
FOR COURT USE ONLY Court of Appeal Case Number (if known):

APP-004

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name):

FAX NO. (Optional):

APPELLANT: RESPONDENT:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: Superior Court Case Number:

JUDGES (all who participated in case):

NOTE TO APPELLANT: You must file this form with the clerk of the Court of Appeal within 10 days after the clerk mails you a notice that this form must be filed. You must attach to this form (1) a copy of the judgment or order being appealed that shows the date it was entered (see Cal. Rules of Court, rule 8.104 for definition of "entered") and (2) proof of service of this form on all parties to the appeal. (CAUTION: An appeal in a limited civil case (Code Civ. Proc., 85) may be taken ONLY to the appellate division of the superior court (Code Civ. Proc., 904.2), or to the superior court (Code. Civ. Proc., 116.710 [small claims cases]).

A.

APPEALABILITY 1. Appeal is from: Judgment after jury trial Judgment after court trial Default judgment Judgment after an order granting a summary judgment motion Judgment of dismissal under Code Civ. Proc., 581d, 583.250, 583.360, or 583.430 Judgment of dismissal after an order sustaining a demurrer An order after judgment under Code Civ. Proc., 904.1(a)(2) An order or judgment under Code Civ. Proc., 904.1(a)(3)(13) Other (describe and specify code section that authorizes this appeal): 2. Does the judgment appealed from dispose of all causes of action, including all cross-actions between the parties? No If no, please explain why the judgment is appealable: Yes

PART I APPEAL INFORMATION

B.

TIMELINESS OF APPEAL (Provide all applicable dates.) 1. 2. 3. Date of entry of judgment or order appealed from: _____/_____/_____ Date that notice of entry of judgment or a copy of the judgment was mailed by the clerk or served by a party under California Rules of Court, rule 8.104: _____/_____/_____ Was a motion for new trial, judgment notwithstanding the verdict, reconsideration, or to vacate the judgment made and denied? Yes No If yes, please specify the type of motion: Date motion filed: _____/_____/_____ Date denied: _____/_____/_____ Date denial served: _____/_____/_____ 4. Date notice of appeal or cross-appeal filed: _____/_____/_____ Yes No (If yes, please attach
Page 1 of 2

C.

BANKRUPTCY OR OTHER STAY Is there a related bankruptcy case or a court-ordered stay that affects this appeal? a copy of the bankruptcy petition [without attachments] and any stay order.)

Form Adopted for Mandatory Use Judicial Council of California APP-004 [Rev. July 1, 2007]

CIVIL CASE INFORMATION STATEMENT
(Appellate)

APP-004
APPELLATE CASE TITLE:
SUPERIOR COURT CASE NUMBER:

D.

E.

APPELLATE CASE HISTORY (Provide additional information, if necessary, on attachment I.D.) Is there now, or has there previously been, any appeal, writ, or other proceeding related to this case pending in any California Yes No If yes, insert name of appellate court: appellate court? Title of case: Appellate court case no.: Trial court case no.: Name of trial court: SERVICE REQUIREMENTS Is service of documents in this matter, including a brief or a petition, required on the Attorney General or other nonparty public officer or agency under California Rules of Court, rule 8.29 or a statute? If yes, please indicate the rule or Yes No statute that applies. Rule 8.29 Bus. & Prof. Code, 17209 (Unfair Competition Act) Bus. & Prof. Code, 17536.5 (False advertising) Civ. Code, 51.1 (Unruh, Ralph, or Bane Civil Rights Acts; antiboycott cause of action; sexual harassment in business or professional relations; civil rights action by district attorney) Civ. Code, 55.2 (Disabled access to public conveyances, accommodations, and housing) Gov. Code, 4461 (Disabled access to public buildings) Gov. Code, 12656(a) (False Claims Act) Health & Saf. Code, 19954.5 (Accessible seating and accommodations) Health & Saf. Code, 19959.5 (Disabled access to privately funded public accommodations) Other (please specify statute):

NOTE: The rule and statutory provisions listed above require service of a copy of a party's brief or petition and brief on the Attorney General or other public officer or agency. Other statutes requiring service on the Attorney General or other public officers or agencies may also apply. (See, e.g., Code Civ. Proc., 1355; Gov. Code, 946.6(d); Pub. Resources Code, 21167.7.)

PART lI NATURE OF ACTION
A. Nature of action (check all that apply): 1. 2. 3. 4. 5. 6. 7. 8. 9. Conservatorship Contract Eminent domain Equitable action a. Declaratory relief b. Family law Guardianship Probate Real property rights a. Title of real property b. Tort b. Medical malpractice a. d. Other personal injury c. e. Other tort (describe): Trust proceedings Writ proceedings in superior court a. Mandate (Code Civ. Proc., 1085) c. Prohibition (Code Civ. Proc., 1102) Other action (describe): This appeal is entitled to calendar preference/priority on appeal (cite authority):

Other (describe):

Other (describe): Product liability Personal property

10. 11.

b. d.

Administrative mandate (Code Civ. Proc., 1094.5) Other (describe):

12. B.

PART III PARTY AND ATTORNEY INFORMATION
Please attach to this form a list of all the parties and all their attorneys of record who will participate in the appeal. For the parties, include the following information: the party's name and his or her designation in the trial court proceeding (plaintiff, defendant, etc.). For the attorneys, include the following information: name, State Bar number, mailing address, telephone number, fax number, and e-mail address. Date: This statement is prepared and submitted by:
(SIGNATURE OF ATTORNEY OR UNREPRESENTED PARTY) APP-004 [Rev. July 1, 2007] Page 2 of 2

CIVIL CASE INFORMATION STATEMENT
(Appellate)