APPELLATE TRANSMITTAL REQUEST FORM

PLEASE FILL OUT COMPLETELY. THANK YOU.

Note: If you have any questions, please email appeals@coloradoorpc.org

If you complete this appellate transmittal sheet, obtain the necessary documents, and submit them to the ORPC within seven days of the final order, appellate counsel will file the notice of appeal.

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GENERAL CASE INFORMATION

COUNTY *

DISTRICT COURT CASE NUMBER (formatted as YYJVSSSS - no leading zeroes; e.g., 21JV1234) *

Case Type *

Please describe: *

JUDGE *

Party Represented *

Mother

Father

TRIAL RPC INFORMATION

Trial RPC First Name *

Trial RPC Last Name *

Trial RPC Bar Number *

Are you an associate attorney? *

Yes

No

If yes, what is the name of your managing attorney? *

Trial RPC Phone Number *

Trial RPC Email Address *

CLIENT INFORMATION

Client's First Name *

Client's Last Name *

Client's Street Address

Address Line 2

City

State

Zip Code

Email Address

Phone Number

Number of Children Subject to Appeal *

CHILD 1 FIRST AND LAST NAME *

CHILD 1 DATE OF BIRTH * +

CHILD 2 FIRST AND LAST NAME *

CHILD 2 DATE OF BIRTH * +

CHILD 3 FIRST AND LAST NAME *

CHILD 3 DATE OF BIRTH * +

CHILD 4 FIRST AND LAST NAME *

CHILD 4 DATE OF BIRTH * +

CHILD 5 FIRST AND LAST NAME *

CHILD 5 DATE OF BIRTH * +

CHILD 6 FIRST AND LAST NAME *

CHILD 6 DATE OF BIRTH * +

ASSISTANT COUNTY ATTORNEY & GUARDIAN AD LITEM INFORMATION

Assistant County Attorney

ACA First Name *

ACA Last Name *

ACA Bar Number *

ACA Email Address *

ACA Phone Number *

ACA Street Address *

Address Line 2

City *

State *

Zip Code *

Trial Guardian Ad Litem

GAL First Name *

GAL Last Name *

GAL Bar Number *

GAL Email Address *

GAL Phone Number *

GAL Street Address *

Address Line 2

City *

State *

Zip Code *

Additional GAL for the Child(ren)? *

Yes

No

ADDITIONAL GUARDIAN AD LITEM INFORMATION

GAL's First Name *

GAL's Last Name *

GAL Bar Number *

GAL Email Address *

GAL Phone Number *

GAL Street Address *

Address Line 2

City *

State *

Zip Code *

APPELLATE DATA

Date of final hearing being appealed: * +

Type of appeal: *

Has a final written order been issued in this case? *

Yes

No

Please upload a PDF copy of the written judgment, decree, or order from which the appeal is taken (mandatory for filing of Notice of Appeal).

A final written order is pending, and trial counsel will email a copy of the order to appellate counsel as soon as it is received. *

I agree

If your client did not appear at the hearing from which you are appealing, please describe the advisement and direction from your client to appeal, including dates of any advisement and direction from your client if possible. If your client did not direct you to appeal, please complete a waiver of appeal or affidavit of efforts to locate instead.

Is your client currently incarcerated? *

Yes

No

If yes, please list the facility and contact information (including counselor if known). *

Proposed Appellate Issues

The following issues were preserved for appellate review or otherwise at issue. *