NOTICE OF APPEAL

(Commonwealth of Kentucky — [County] Circuit Court)

1. CAPTION

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COMMONWEALTH OF KENTUCKY
[COUNTY_NAME] CIRCUIT COURT
CIVIL ACTION NO. [CASE_NUMBER]

[PLAINTIFF_NAME],
Plaintiff,

v.

[DEFENDANT_NAME],
Defendant.

Attorney Information

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[ATTORNEY_NAME] (KY Bar No. [BAR_NUMBER])
[LAW_FIRM_NAME]
[ADDRESS]
[City], Kentucky [ZIP]
Telephone: [PHONE] | Facsimile: [FAX]
Email: [EMAIL]
Counsel for Appellant [CLIENT_NAME]

2. NOTICE

Pursuant to Kentucky RAP 3 and 4, [CLIENT_NAME], [trial court role], hereby appeals to the [Kentucky Court of Appeals / Supreme Court of Kentucky] from the judgment/order entered on [JUDGMENT_DATE] by the Honorable [JUDGE_NAME]. The judgment [brief description] and is appealable under RAP 3(A) and KRS 22A.020([subsection]).

3. TIMELINESS

• Date judgment noted in docket: [JUDGMENT_DATE]
• Date notice of entry served: [SERVICE_DATE]
• Post-judgment motions (CR 50.02/52.02/59.05) and disposition: [DETAILS]
• Date of filing of this notice: [FILING_DATE]

4. STATEMENT OF POINTS (SUMMARY)

1. [POINT_ONE]
2. [POINT_TWO]
3. [POINT_THREE]

5. RECORD AND TRANSCRIPT (RAP 11)

Appellant will request preparation of transcripts from [COURT_REPORTER] for proceedings held on [HEARING_DATES] and will file Form AOC-060 within 10 days. Directions to the clerk for record assembly will be submitted per RAP 12.

6. FILING FEE AND BOND

Appellant has [paid the filing fee / filed motion to proceed in forma pauperis]. Any supersedeas bond to stay enforcement will be sought under RAP 7 and CR 73.04.

7. RELIEF REQUESTED

Appellant requests reversal, modification, or remand of the identified judgment/order and any additional relief deemed appropriate, including costs on appeal.

8. SIGNATURE BLOCK

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Respectfully submitted this [DATE].

[ATTORNEY_NAME]
Counsel for Appellant [CLIENT_NAME]

9. CERTIFICATE OF SERVICE (RAP 5)

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I certify that a true and correct copy of the foregoing NOTICE OF APPEAL was served on [SERVICE_DATE] via ☐ eFiling ☐ U.S. Mail ☐ Hand Delivery ☐ Email (consent) upon:

☐ [NAME], Counsel for [PARTY], [ADDRESS/EMAIL]
☐ Clerk of the [COUNTY_NAME] Circuit Court

[SERVER_NAME]