Proposed Statement On Appeal (Limited Civil Case) {APP-104}

APP-104, Proposed Statement on Appeal (Limited Civil Case), this form is used to give the trial court and the other parties in an appeal in a limited civil case your draft summary of the oral (spoken) proceedings in the case in the trial court (proposed statement on appeal). Use this form only if you are the appellant and you chose to use a statement or appeal in your notice designating the record on appeal. You must use this form if you are preparing a proposed statement on appeal and you are not represented by an attorney for the appeal. 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. • This form can be attached to your Appellant’s Notice Designating Record on Appeal (Limited Civil Case) (form APP-103). If it is not attached to that notice, this form must be filed no later than 20 days after you file that 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. • Serve a copy of the completed form on each of the other parties and keep proof of this service. You can get information about how to serve court papers and proof of service from What Is Proof of Service? (form APP-109-INFO). • 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 clerk and ask the clerk to stamp it to show that the original has been filed. Judicial Council of California Rev. January 1, 2021, Optional Form Cal. Rules of Court, rule 8.837 www.FormsWorkflow.com