Free USCA Case Number - District Court of Arizona - Arizona

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FOR THE NINTH CIRCUIT ___,..
NOTICE OF APPEAL NOTIFICATION FORM Fu"§< TED,-_____________ ,...1.
Court of Appeals No. DO - DATE "`"mi
case INFORMATION: O
Short Case Title: Lopez vs AZ Industrial Commission 5 -—-
District, Division & Judge AZ - PHX — Judge Roslyg O Silver
District Court Case No. CV 04-128 PHX-ROS
Date Complaint Filed: l/21/O4
Date Appealed order entered: 9/15/05
Date NOAji/ed: 12/ 12/05
Date of Indictment/Information Plea Hearing Sentencing
E COA Status (check one): U granted in full (attach order) _ E! denied in full (send record) _ ) gg
I3 granted in part (attach order) El pending I l { — l
III no COA required (2241)
El Certificate of Record included — No Court Reporter
Court Reporter(s) Name & Phone Number: Laurie Adams 602-322-7256
Magistrate J'udge’s Order? It so, please attach.
FEE INFORMATION
Date Docket Fee Paid: Date Docket Fee Billed:
Date IFP granted: l/26/O4 Date IFP denied:
Is IFP pending? U yes El no Was IFP limited U? Revoked D?
US Government Appeal? El yes E! no
Companion Cases? Please list:
Please attach cozy of any order granting, denying or revoking LFP.
COUNSEL INFORMATION (please include email address)
Appellate Counsel: Appellee Counsel:
W"? El retained El CJA CI FPD |2lPro Se El Other ----- Please attach appointmetzt order.
E See attached docket for names/addresses/phone numbers
DEFENDANT INFORMATION A
Prisoner ID Address:
Custody EJ yes U no Bail

Other docs included in this packet:
Name & Phone Number of Person Completing this Form: sf Linda S. Patton
602-322-7221
Ninth Circuit - Please acknowledge receipt of this appeal on the enclosed copy.
Case 2:04-cv—00128-ROS Document 30 Filed 12/29/2005 Page 1 of 1

Case 2:04-cv-00128-ROS

Document 30

Filed 12/29/2005

Page 1 of 1