AOC-262 Rev. 4-01 Page 1 of 1
Doc. Code: NAAB
01/9/2007 11:39 am
Case No. Court NOTICE OF APPEAL ON DENIAL OF SELF-CONSENT ABORTION BY A MINOR County
Ver. 1.01
Commonwealth of Kentucky Court of Justice KRS 311.732
IN RE: SELF-CONSENT FOR AN ABORTION BY A MINOR Comes the Petitioner, ________, a minor under the age of 18, (check one)
(initials)
by herself; by counsel; or by her next friend _____________________________________________________________, (Name) and gives Notice of Appeal to the Kentucky Court of Appeals of the Order of this Court denying Petitioner's Petition for Self-Consent for Abortion by a Minor rendered on _______________, 2______.
Initials of Petitioner: Signature of Petitioner's Next Friend: Signature of Petitioner's Counsel:
_____________ ______________________________________ ______________________________________
NOTICE TO CLERK: Completion and certification of the record on appeal shall be completed within five (5) calendar days of the filing of the Notice of Appeal in the trial court. Pursuant to special rules of the Kentucky Supreme Court, all information relating to this proceeding shall be confidential; shall not be a public record; and shall not be released to the public.
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