STATE OF NEBRASKA FORM NO. Appendix 2 Rev. 2/09 Chapter 6, Article 14
CERTIFICATE OF CIVIL APPEAL
CASE NUMBER: _____________________
IN THE COUNTY COURT OF
COUNTY, NEBRASKA
vs.
Plaintiff
Attorney: Address: Telephone: Attorney: Address: Telephone:
No.
Defendant
No.
I certify that the attached are true and accurate copies of pleadings filed in the above-captioned case. The case is a civil case originating in the County Court: Adoption Inheritance Tax Juvenile Probate Adjudication Guardianship Termination Criminal Notice of appeal directed to: Court of Appeals OR Statutory The notice of appeal was filed on The statutory docket fee was paid on a poverty affidavit was filed on All motions for new trial have been disposed of: Yes. Date: No No motions for new trial filed. Date: (SEAL) Clerk Magistrate By: Supreme Court Authority: Constitutionality of statute . . ; or