Form APP-104 Proposed Statement on Appeal (Limited Civil Case) - California

Form APP-104 is a California Court of Appeal form also known as the "Proposed Statement On Appeal (limited Civil Case)". The latest edition of the form was released in January 1, 2017 and is available for digital filing.

Download an up-to-date Form APP-104 in PDF-format down below or look it up on the California Court of Appeal Forms website.

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Clerk stamps date here when form is filed.
Proposed Statement on Appeal
APP-104
(Limited Civil Case)
Instructions
This form is only for preparing a proposed statement on appeal in a limited
civil case.
Before you fill out this form, read Information on Appeal Procedures for
Limited Civil Cases (form APP-101-INFO) to know your rights and
responsibilities. You can get form APP-101-INFO at any courthouse or
county law library or online at www.courts.ca.gov/forms.
You fill in the name and street address of the court
This form can be attached to your Appellant’s Notice Designating Record
that issued the judgment or order you are
on Appeal (Limited Civil Case) (form APP-103). If it is not attached to that
appealing:
notice, this form must be filed no later than 20 days after you file that
Superior Court of California, County of
notice. If you have chosen to prepare a statement on appeal and do not
file this form on time, the court may dismiss your appeal.
Fill out this form and make a copy of the completed form for your records
and for each of the other parties.
You fill in the number and name of the trial court
Serve a copy of the completed form on each of the other parties and keep
case in which you are appealing the judgment or
proof of this service. You can get information about how to serve court
order:
papers and proof of service from What Is Proof of Service? (form
Trial Court Case Number:
APP-109-INFO) and on the California Courts Online Self-Help Center at
www.courts.ca.gov/selfhelp-serving.htm.
Trial Court Case Name:
Take or mail the original completed form and proof of service on the other
parties to the clerk’s office for the same court that issued the judgment or
order you are appealing. It is a good idea to take or mail an extra copy to the
You fill in the appellate division case number (if
clerk and ask the clerk to stamp it to show that the original has been filed.
you know it):
Appellate Division Case Number:
Your Information
1
a.
Name of Appellant (the party who is filing this appeal):
Name:
b.
Appellant’s contact information (skip this if the appellant has a lawyer for this appeal):
Street address:
Street
City
State
Zip
Mailing address (if different):
Street
City
State
Zip
Phone:
E-mail:
c.
Appellant’s lawyer (skip this if the appellant does not have a lawyer for this appeal):
Name:
State Bar number:
Street address:
Street
City
State
Zip
Mailing address (if different):
Street
City
State
Zip
Phone:
E-mail:
Fax:
Judicial Council of California, www.courts.ca.gov
Proposed Statement on Appeal
APP-104,
Page 1 of 7
Revised January 1, 2017, Optional Form
(Limited Civil Case)
Cal. Rules of Court, rule 8.837
Clerk stamps date here when form is filed.
Proposed Statement on Appeal
APP-104
(Limited Civil Case)
Instructions
This form is only for preparing a proposed statement on appeal in a limited
civil case.
Before you fill out this form, read Information on Appeal Procedures for
Limited Civil Cases (form APP-101-INFO) to know your rights and
responsibilities. You can get form APP-101-INFO at any courthouse or
county law library or online at www.courts.ca.gov/forms.
You fill in the name and street address of the court
This form can be attached to your Appellant’s Notice Designating Record
that issued the judgment or order you are
on Appeal (Limited Civil Case) (form APP-103). If it is not attached to that
appealing:
notice, this form must be filed no later than 20 days after you file that
Superior Court of California, County of
notice. If you have chosen to prepare a statement on appeal and do not
file this form on time, the court may dismiss your appeal.
Fill out this form and make a copy of the completed form for your records
and for each of the other parties.
You fill in the number and name of the trial court
Serve a copy of the completed form on each of the other parties and keep
case in which you are appealing the judgment or
proof of this service. You can get information about how to serve court
order:
papers and proof of service from What Is Proof of Service? (form
Trial Court Case Number:
APP-109-INFO) and on the California Courts Online Self-Help Center at
www.courts.ca.gov/selfhelp-serving.htm.
Trial Court Case Name:
Take or mail the original completed form and proof of service on the other
parties to the clerk’s office for the same court that issued the judgment or
order you are appealing. It is a good idea to take or mail an extra copy to the
You fill in the appellate division case number (if
clerk and ask the clerk to stamp it to show that the original has been filed.
you know it):
Appellate Division Case Number:
Your Information
1
a.
Name of Appellant (the party who is filing this appeal):
Name:
b.
Appellant’s contact information (skip this if the appellant has a lawyer for this appeal):
Street address:
Street
City
State
Zip
Mailing address (if different):
Street
City
State
Zip
Phone:
E-mail:
c.
Appellant’s lawyer (skip this if the appellant does not have a lawyer for this appeal):
Name:
State Bar number:
Street address:
Street
City
State
Zip
Mailing address (if different):
Street
City
State
Zip
Phone:
E-mail:
Fax:
Judicial Council of California, www.courts.ca.gov
Proposed Statement on Appeal
APP-104,
Page 1 of 7
Revised January 1, 2017, Optional Form
(Limited Civil Case)
Cal. Rules of Court, rule 8.837
Trial Court Case Number:
Trial Court Case Name:
Information About Your Appeal
2
On (fill in the date):
, I/my client filed a notice of appeal in the trial court case identified
in the box on page 1 of this form.
3
On (fill in the date):
, I/my client filed a notice designating the record on appeal, electing
to use a statement on appeal.
Proposed Statement
Reasons for Your Appeal
4
Remember, in an appeal, the appellate division can only review a case for whether certain kinds of legal errors
were made (read form APP-101-INFO to learn about these legal errors):
There was not “substantial evidence” supporting the judgment, order, or other decision you are appealing.
A “prejudicial error” was made during the trial court proceedings.
The appellate division:
Cannot retry your case or take new evidence.
Cannot consider whether witnesses were telling the truth or lying.
Cannot consider whether there was more or stronger evidence supporting your position than there was
supporting the trial court’s decision.
(Check all that apply and describe the legal error or errors you believe were made that are the reason for this
appeal.)
a.
There was not substantial evidence that supported the judgment, order, or other decision that I/my client
indicated in the notice of appeal is being appealed in this case. (Explain why you think the judgment, order,
or other decision was not supported by substantial evidence):
b.
The following error or errors about either the law or court procedure was/were made that caused substantial
harm to me/my client. (Describe each error and how you were/your client was harmed by that error.)
(1) Describe the error:
Describe how you were/your client was harmed by the error:
Revised January 1, 2017
APP-104,
Proposed Statement on Appeal
Page 2 of 7
(Limited Civil Case)
Trial Court Case Number:
Trial Court Case Name:
(2) Describe the error:
Describe how you were/your client was harmed by the error:
(3) Describe the error:
Describe how you were/your client was harmed by the error:
Check here if you need more space to describe these or other errors and attach a separate page or pages
describing the errors. At the top of each page, write “APP-104, item 4.”
The Dispute
5
a. In the trial court, I/my client was the (check one):
plaintiff (the party who filed the complaint in the case).
defendant (the party against whom the complaint was filed).
b. The plaintiff’s complaint in this case was about (briefly describe what was claimed in the complaint filed with
the trial court):
c. The defendant’s response to this complaint was (briefly describe how the defendant responded to the complaint
filed with the trial court):
Check here if you need more space to describe the dispute and attach a separate page or pages describing it.
At the top of each page, write “APP-104, Item 5.”
Revised January 1, 2017
APP-104,
Proposed Statement on Appeal
Page 3 of 7
(Limited Civil Case)
Trial Court Case Number:
Trial Court Case Name:
Summary of Any Motions and the Court's Order on the Motion
6
a.
Were any motions (requests for the trial court to issue an order) made in this case that are relevant to the reasons
you gave in
4
for this appeal?
Yes (fill out b)
No (skip to
)
7
b.
In the spaces below, describe any motions (requests for orders) that were made in the trial court that are
relevant to the reasons you gave in
for this appeal. Write a complete and accurate summary of what was
4
said at any hearings on these motions and indicate how the trial court ruled on these motions.
(1) Describe the first motion:
The motion was filed by the
plaintiff.
defendant.
There
was
was not
a hearing on this motion.
If there was a hearing on this motion, write a complete and accurate summary of what was said at this
hearing:
did not grant this motion.
The trial court
granted this motion.
Other
(describe any other action the trial court took concerning this motion):
Check here if you need more space to describe this motion and attach a separate page or pages
describing this motion. At the top of each page, write “APP-104, Item 6b(1).”
Describe the second motion:
(2)
The motion was filed by the
plaintiff.
defendant.
There
was
was not
a hearing on this motion.
If there was a hearing on this motion, write a complete and accurate summary of what was said at this
hearing:
did not grant this motion.
The trial court
granted this motion.
Revised January 1, 2017
APP-104,
Proposed Statement on Appeal
Page 4 of 7
(Limited Civil Case)
Trial Court Case Number:
Trial Court Case Name:
Other
(describe any other action the trial court took concerning this motion):
Check here if you need more space to describe this motion and attach a separate page or pages
describing this motion. At the top of each page, write “APP-104, item 6b(2).”
(3)
Check here if any other motions were filed that are relevant to the reasons you gave in
4
for this
appeal and attach a separate page describing each motion, identifying who made the motion and whether
there was a hearing on the motion, summarizing what was said at the hearing on the motion, and
indicating whether the trial court granted or denied the motion. At the top of each page, write “APP-104,
item 6b(3).”
Summary of Testimony and Other Evidence
7
a.
Was there a trial in your case?
No (skip items b, c, d, and e and go to item
8
)
Yes (check (1) or (2) and complete items b, c, d, and e)
(1)
Jury trial
(2)
Trial by judge only
b.
Did you/your client testify at the trial?
No
Yes (Write a complete and accurate summary of the testimony you/your client gave that is relevant to the
reasons you gave in
for this appeal. Include only what you actually said; do not comment or give your
4
opinion about what was said. Please indicate whether any objections were made concerning your/your
client’s testimony or any exhibits you/your client asked to present and whether these objections were
sustained.):
Check here if you need more space to summarize your/your client’s testimony and attach a separate
page or pages summarizing this testimony. At the top of each page, write “APP-104, Item 7b.”
4
c.
Were there any other witnesses at the trial whose testimony is relevant to the reasons you gave in
for this
appeal?
No
Yes (complete items (1), (2), and (3)):
(1)
The witness’s name is (fill in the witness’s name):
(2)
The witness testified on behalf of the (check one):
plaintiff.
defendant.
Revised January 1, 2017
APP-104,
Proposed Statement on Appeal
Page 5 of 7
(Limited Civil Case)

Download Form APP-104 Proposed Statement on Appeal (Limited Civil Case) - California

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