Docketing Statement E {COA-E}

COA-E (rev. 1/18)IN THE COURT OF APPEALS OF THE STATE OF ALASKADOCKETING STATEMENT EFOR USE IN SENTENCE APPEALS UNDER APPELLATE RULE 215Appeal filed by DefendantState of Alaska (for court system use) No. 1.DEFENDANT a.Nameb.Did defendant have co-counselstatus in the trial court? YESNO c.Defendant Mailing Address * (not attorney's address)Will defendant seek co-counselstatus in the appellate court? YESNO UNKNOWN CityStateZip Code d.Telephone *5.TRIAL COURT PROCEEDING a.Case No. b.Trial Judge * c.Date Judgment Distributed * d.Post-Judgment Motions: List all post-judgment motions that affect time for filing appeal. See Appellate Rule 204(a)(4). DATE OF FILING DATE ORDER DISTRIBUTED Month Day Year Type of Post-Judgment Motion Month Day Year *Include probation revocation judge and date of distribution of probation revocation order, if applicable. Defendant not represented by attorney in appeal. a.NameCourt Apptd b.Bar Number c.Attorney Mailing Address d.Telephone e.Fax StateCity Zip f.Firm/Agency 3.DEFENDANT'S ATTORNEY IN TRIAL COURT Same as attorney in appeal.Defendant not represented by attorney in trial court. a.Name b.Bar Number c.Attorney Mailing Address d.Telephone e.Fax StateCity Zip f.Firm/Agency 4.PROSECUTING ATTORNEY * a.Name b.Bar Number c.Attorney Mailing Address d.Telephone e.Fax StateCity Zip f.Firm/Agency*Specify attorney who will handle appeal, if known. Otherwise, specify trial attorney.2.DEFENDANT'S ATTORNEY IN APPEAL American LegalNet, Inc. www.FormsWorkFlow.com COA-E (rev. 1/18)5.TRIAL COURT PROCEEDING (continued)e.Co-Defendants: List all co-defendants in trial court proceeding. Co-Defendant's Name Co-Defendant's Trial Court Case No. f.Related Cases in the Trial Court: List all related trial court cases involving defendant (e.g., post-conviction relief proceeding underCriminal Rule 35.1, separate trial of defendant on related charges). DATE OF FILING Month Day Year Type of Proceeding Trial Court Case No. 6.SENTENCE BEING APPEALED Provide following information for each sentence being appealed: Count SENTENCE PART OF SENTENCE BEING APPEALED No. Offense Jail Fine Other (specify) Jail Fine Other (specify) The following items are submitted with this form:A copy of the final order or judgment from which the appeal is taken.A $250 filing fee or a motion to appeal at public expense (financial statement affidavit form must be included).b.a motion to waive filing fee (financial statement affidavit form must be included).no filing fee is required because appellant isrepresented by court-appointed counsel.the State of Alaska. a. I certify that I have reviewed Appellate Rule 215(a)(1) and that I believe this appeal is within the jurisdiction of the Court of Appeals as stated therein.DateSignature of Appellant or Appellant's Attorney 8.ATTORNEY INFORMATION* a.Name b.Bar Number c.Attorney Mailing Address d.Telephone e.Fax StateCity Zip f.Firm/Agency*Complete this box only if the attorney who signs form is not the attorney named in box 2, 3, or 4. CERTIFICATE OF SERVICEFILING INSTRUCTIONSI certify that onmaileddeliveredto All parties in the trial court (listed)Signature: a copy of the notice of appeal, this docketing statement, and all attachments (except filing fee) were File original docketing statement and notice of appeal with all attach- ments listed in #7 and ONE copy of All except filing fee. 7.ATTACHMENTS American LegalNet, Inc. www.FormsWorkFlow.com