Superior Court - Appellate Division
New Jersey Judiciary
Type or clearly print all information. Attach additional sheets if necessary.
NAME
Revised effective 9/01/2008 Page 1 of 2
TITLE IN FULL (AS CAPTIONED BELOW):
NOTICE OF APPEAL
ATTORNEY / LAW FIRM / PRO SE LITIGANT
TRIAL COURT OR STATE AGENCY
ON APPEAL FROM
TRIAL COURT OR AGENCY NUMBERTRIAL COURT JUDGE
Notice is hereby given that ____________________________________ appeals to the Appellate
Division from a Judgment or Order entered on ______________________ in the Civil
Criminal or Family Part of the Superior Court or from a State Agency decision entered on
_______________.
If not appealing the entire judgment, order or agency decision, specify what parts or paragraphs are
being appealed.
Have all issues, as to all parties in this action, before the trial court or agency been disposed of? (In
consolidated actions, all issues as to all parties in all actions must have been disposed of.) Yes No
If not, has the order been properly certifi ed as fi nal pursuant to R. 4:42-2? Yes No
For criminal, quasi-criminal and juvenile actions only:
Give a concise statement of the offense and the judgment including date entered and any sentence
or disposition imposed:
Is defendant incarcerated? Yes No
Was bail granted or the sentence or disposition stayed? Yes No
If in custody, name the place of confi nement:
EMAIL ADDRESS
STREET ADDRESS
CITY STATE ZIP PHONE NUMBER
This appeal is from a conviction post judgment motion post-conviction relief.
If post-conviction relief, is it the 1st 2nd other _________________________
Defendant was represented below by:
Public Defender self private counsel ______________________________________________
specify
specify
Page 2 of 2
Notice of appeal and attached case information statement have been served where applicable on the
following:
Name Date of Service
Trial Court Judge
Trial Court Division Manager
Attorney General or Attorney for other
Governmental body pursuant to
R. 2:5-1(a), (e) or (h)
Other parties in this action:
Name and Designation Attorney Name, Address and Telephone No. Date of Service
Attached transcript request form has been served where applicable on the following:
Name Date of
Service Amount of Deposit
Supervisor of Court Reporters
Trial Court Transcript Offi ce
Exempt from submitting the transcript request form due to the following:
No verbatim record.
Transcript in possession of attorney or pro se litigant (four copies of the transcript must be sub-
mitted along with an electronic copy).
List the date(s) of the trial or hearing:
Motion for abbreviation of transcript fi led with the court or agency below. Attach copy.
Motion for free transcript fi led with the court below. Attach copy.
I certify that the foregoing statements are true to the best of my knowledge, information and belief.
I also certify that, unless exempt, the fi ling fee required by N.J.S.A. 22A:2 has been paid.
DATE SIGNATURE OF ATTORNEY OR PRO SE LITIGANT
State Agency
Tax Court Administrator
State Agency
Court Reporter (if applicable)
Clerk of the Tax Court
