Name  

Address  

City, State, Zip  

Phone  

Fax  

E-Mail  

G FPD G Appointed G CJA G Pro Per G Retained 

UNITED STATES DISTRICT COURT 

CENTRAL DISTRICT OF CALIFORNIA 

CASE NUMBER:  

PLAINTIFF(S), 

NOTICE OF APPEAL 

DEFENDANT(S). 

NOTICE IS HEREBY GIVEN that hereby appeals to Name of Appellant 

the United States Court of Appeals for the Ninth Circuit from: 

Criminal Matter Civil Matter 

G Conviction only [F.R.Cr.P. 32(j)(1)(A)]  G Conviction and Sentence 

G Sentence Only (18 U.S.C. 3742) G Pursuant to F.R.Cr.P. 32(j)(2) 

G Interlocutory Appeals 

G Sentence imposed: 

G Bail status: 

G Order (specify): G Judgment (specify): G Other (specify): 

Imposed or Filed on . Entered on the docket in this action on . A copy of said judgment or order is attached hereto. 

Date Signature 

G Appellant/ProSe G Counsel for Appellant G Deputy Clerk 

Note: The Notice of Appeal shall contain the names of all parties to the judgment or order and the names and addresses of the attorneys for each party. Also, if not electronically filed in a criminal case, the Clerk shall be furnished a sufficient number of copies of the Notice of Appeal to permit prompt compliance with the service requirements of FRAP 3(d).

A-2 (01/07) NOTICE OF APPEAL 

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