Free Kentucky Court of Appeals Civil Appeal Hearing Statement - Kentucky

AOC-070 01/22/2009 10:40 am Rev. 12-03 Ver. 1.01 Page 1 of 2 Commonwealth of Kentucky Court of Justice www.kycourts.net CR 76.03(3)
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KENTUCKY COURT OF APPEALS CIVIL APPEAL PREHEARING STATEMENT
Other

Individual

APPELLANT

VS.
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COURT OF APPEALS DOCKET NO. _______________________________ (leave blank) APPELLEE Other Individual

Appeal From ___________________________ Circuit Court

Action No. ____________________________________

Trial Judge: ________________________________ Judgment/Order Appealed From Entered: ___________________ Notice of Appeal Filed: _______________________ Notice of Cross Appeal Filed: _____________________________ Identifying Information Regarding Counsel for APPELLANT: Name of Client _______________________________________________________________________________ ___________________________________________________________________________________________ In the trial court, this party was the [ ] Plaintiff [ ] Defendant [ ] Other (specify) ___________________________ Attorney's Name: _____________________________________________________________________________ Address: __________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Telephone No. _________________________________

Identifying Information Regarding Counsel for APPELLEE: Name of Client _______________________________________________________________________________ ___________________________________________________________________________________________ In the trial court, this party was the [ ] Plaintiff [ ] Defendant [ ] Other (specify) ___________________________ Attorney's Name: _____________________________________________________________________________ Address: __________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Telephone No. _________________________________

1. Has this case been before an Appellate Court previously? [ ] Yes

[ ] No

If Yes, provide date and prior case number(s)________________________________________________________ 2. Type of litigation (type of order; e.g., automobile negligence, breach of contract, domestic, product liability, property dispute, tax, UCC, zoning, etc.). Attach copy of complaint or other document initiating Circuit Court action. ____________________________________________________________________________________________ ____________________________________________________________________________________________ 3. Was this case mediated at the trial court level? [ ] Yes [ ] No

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AOC-070 Rev. 12-03 Page 2 of 2 4. Circuit Court Disposition (type of order; e.g., Default or Summary Judgment, Dismissal, etc.). Attach copy of final judgment and any separate written opinion by trial court. ____________________________________________________________________________________________ ____________________________________________________________________________________________ 5. Relief: (a) Damages: (b) Injunction: (c) Amount Sought $ ____________________ Amount Granted $ ________________ [ ] Granted [ ] Denied

Other:______________________________________________________________________________

_____________________________________________________________________________________ 6. Facts and Issues: (Brief statement of facts, claims, defenses and issues litigated. Attach separate sheet if necessary). ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 7. Briefly state issues proposed to be raised on appeal, including jurisdictional challenges, and any question of first impression. Attach separate sheet if necessary. ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ 8. Will the appeal turn on interpretation or application of a particular case or statute? [ ] Yes [ ] No If Yes, identify case/statute: ______________________________________________________________________ 9. Is there any known case involving substantially the same issue now pending before either appellate court of this state? [ ] Yes [ ] No If Yes, give Case Number: _________________________________________________ Case Name: __________________________________________________________________________________ 10. Would a prehearing conference be helpful? [ ] Yes [ ] No Why? ______________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ CERTIFICATION I/We hereby certify a copy of the foregoing statement was executed and a copy served on:

_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________
Date: ______________________________________________ Signature Print Name: _________________________________________________________________________________ Address: ___________________________________________________________________________________ _________________, 2______.

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NOTES: 1) Items 2 and 4 on page 1 require documents to be attached to this Form for proper filing. 2) Filing of Civil Notice of Appeal suspends running of time for further appeal steps-See CR 76.03(14).