Notice Of Appeal (To Circuit Court From Decision And Order Of Agency Board Commission Or Officer) (Sample And Form) {3}

Your Name, Address and Telephone Number IN THE CIRCUIT COURT OF THE STATE OF HAWAII Your Name CIRCUIT Appellant, v. Name of Government Official or Agency Appellee(s). ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Civil No. Agency Docket/Case No. NOTICE OF APPEAL TO THE CIRCUIT COURT; STATEMENT OF THE CASE; EXHIBIT A; DESIGNATION OF RECORD ON APPEAL; ORDER FOR CERTIFICATION AND TRANSMISSION OF RECORD; CERTIFICATE OF SERVICE NOTICE OF APPEAL TO THE CIRCUIT COURT Notice is hereby given that Your Name , , Hawaii List statutes that give right to appeal Appellant above-named, pursuant to section Revised Statutes, and Rule 72 of the Hawaii Rules of Civil Procedure, hereby appeals to the Circuit Court of the Circuit from the of Name of Government Official or Agency entered on Date order or decision filed . A copy of the is attached as Exhibit A. Date document signed DATED: City and State you are in Type or Print Your Name Here HRAP Form 3 (10/2012) Reprographics (05/13) SC BEI-508 Certified American LegalNet, Inc. www.FormsWorkFlow.com SC-P-329