Superior Court - Appellate Division
New Jersey Judiciary
Please type or clearly print all information.
Revised effective 9/01/2008 Page 1 of 2
TITLE IN FULL
CRIMINAL CASE INFORMATION STATEMENT
PLAINTIFF DEFENDANT OTHER (SPECIFY)
TRIAL COURT DOCKET NUMBER
APPELLANT’S ATTORNEY
NAME CLIENT
MAILING ADDRESS CITY STATE ZIP TELEPHONE NUMBER
RESPONDENT’S ATTORNEY
NAME CLIENT
MAILING ADDRESS CITY STATE ZIP TELEPHONE NUMBER
GIVE DATE AND SUMMARY OF JUDGMENT OR ORDER BEING APPEALED AND ATTACH A COPY:
Are there any issues below in this action involving defendant which have not been disposed of?
(If so, leave to appeal must be sought. R. 2:2-4, 2:5-6)
Is the validity of a statute, regulation, executive order, franchise or constitutional provision of this State being questioned?
(R. 2:5-1(h))
YES NO
YES NO
GIVE A BRIEF STATEMENT OF THE FACTS AND PROCEDURAL HISTORY:
TO THE EXTENT POSSIBLE, LIST THE PROPOSED ISSUES TO BE RAISED ON THE APPEAL AS THEY WILL BE DESCRIBED IN
APPROPRIATE POINT HEADINGS PURSUANT TO R. 2:6-2(a)(5). (Appellant or cross-appellant only.):
Is defendant presently confi ned? YES NO
If not, is defendant on bail? YES NO
Provide any State Bureau of Identifi cation (SBI) number and date of birth: ___________________________ / __________________
Will the issue(s) in this appeal involve only whether the trial court imposed a proper sentence? YES NO
If so, briefs shall not be fi led without leave of court. (R. 2:9-11)
Are there co-defendants? YES NO
If so, state their names and whether they were tried with the defendant or shared any pretrial motion.
EMAIL ADDRESS:
EMAIL ADDRESS:
(For use in Criminal, Quasi-Criminal and Juvenile Actions)
Page 2 of 2
3. Will the trial judge be fi ling a statement or an opinion pursuant to R. 2:5-1(b)? YES NO
1. IS THERE ANY CASE NOW PENDING OR ABOUT TO BE BROUGHT BEFORE THIS COURT WHICH:
(A) Arises from substantially the same case or controversy as this appeal?
(B) Involves an issue that is substantially the same, similar or related to an issue in this appeal?
2. WAS THERE ANY PRIOR APPEAL INVOLVING THIS CASE OR CONTROVERSY?
YES NO
YES NO
YES NO
IF THE ANSWER TO EITHER 1 OR 2 ABOVE IS YES, STATE:
Case Name and Type (direct, 1st PCR, other, etc.): Appellate Division Docket Number:
Name of Appellant or Respondent Name of Counsel of Record
Date Signature of Counsel of Record
IF YOU ARE APPEALING FROM A JUDGMENT ENTERED BY A TRIAL JUDGE SITTING WITHOUT A JURY OR FROM AN ORDER OF THE
TRIAL COURT, COMPLETE THE FOLLOWING:
1. Did the trial judge issue oral fi ndings or an opinion? If so, on what date? ___________________
2. Did the trial judge issue written fi ndings or an opinion? If so, on what date? ___________________
YES NO
YES NO
Caution: Before you indicate that there was neither fi ndings nor an opinion, you should inquire of the trial judge to determine whether fi ndings or
an opinion was placed on the record out of counsel’s presence or whether the judge will be fi ling a statement or opinion pursuant to R. 2:5-1(b).
DATE OF YOUR INQUIRY: ____________________
(Attach a copy.)
(or your name if not represented by counsel)
(or your signature if not represented by counsel)
