Respondent’s Notice Designating 
Record on Appeal 
(Limited Civil Case)

Clerk stamps date here when form is filed.

APP-110

Instructions

•

•

•

•

This form is only for choosing (“designating”) the record 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. You can get form APP-101-INFO at any courthouse or 
county law library or online at www.courts.ca.gov/forms.

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) or on the California Courts Online Self-Help Center at 
www.courts.ca.gov/selfhelp-serving.htm.

You fill in the name and street address of the court 
that issued the judgment or order you are  
appealing:
Superior Court of California, County of

You fill in the number and name of the trial court  
case in which you are appealing the judgment or  
order:

Trial Court Case Number:

• 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 that is being appealed. 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.

Trial Court Case Name:

1

Your Information

You fill in the appellate division case number (if  
you know it):

Appellate Division Case Number:

a.

Name of respondent (the party who is responding to an appeal filed  
by another party):

Name:

b.

Respondent’s contact information (skip this if the respondent has a lawyer for this appeal):   

c.

Respondent’s lawyer (skip this if the respondent does not have a lawyer for this appeal): 

State Bar number:

Street address: 

Street

Mailing address (if different): 

Phone: 

Street

E-mail:

Name:

Street address: 

Street

Mailing address (if different): 

Phone: 
Fax:

Street

E-mail:

City

City

City

City

State

Zip

State

Zip

State

Zip

State

Zip

Judicial Council of California 
www.courts.ca.gov  
Revised January 1, 2019, Optional Form 
Cal. Rules of Court, rules 8.831, 8.832, 8.834

Respondent's Notice Designating Record on Appeal 
(Limited Civil Case)

APP-110, Page 1 of 5

Trial Court Case Name:

Information About the Appeal

Trial Court Case Number:

2

3

4

On (fill in the date):
trial court case identified in the box on page 1 of this form.

another party filed a notice of appeal in the 

On (fill in the date):
designating the record on appeal.

         the appellant filed an appellant’s notice 

Record of the Documents Filed in the Trial Court

The appellant elected (chose) to use a clerk’s transcript under rule 8.832 as the record of the documents filed in the 
trial court.
a.

Additional documents or exhibits. If you want any documents or exhibits in addition to those designated by 
the appellant to be included in the clerk’s transcript, you must identify those documents here.

(1)

Documents

In addition to the documents designated by the appellant, I request that the clerk include in the transcript 
the following documents that were filed in the trial court. (Identify each document you want included by 
its title and provide the date it was filed or, if that is not available, the date the document was signed).

Document Title and Description

Date of Filing

(a)

(b)

(c)

(d)

(2)

Exhibits

Check here if you need more space to list other documents and attach a separate page or pages listing 
those documents. At the top of each page, write “APP-110, item 4a(1).”

I request that the clerk include in the transcript the following exhibits that were admitted in evidence,  
refused, or lodged in the trial court. (For each exhibit, give the exhibit number (such as Plaintiff’s #1 or  
Defendant’s A) and a brief description of the exhibit and indicate whether or not the court admitted the  
exhibit into evidence. If the trial court has returned a designated exhibit to a party, the party who has  
that exhibit must deliver it to the trial court clerk as soon as possible.)

Exhibit Number

Description

Admitted Into Evidence

Yes

Yes

Yes

Yes

No

No

No

No

Check here if you need more space to list other exhibits and attach a separate page or pages listing 
those exhibits. At the top of each page, write “APP-110, item 4a(2).”

Revised January 1, 2019 

Respondent's Notice Designating Record on Appeal 
(Limited Civil Case)

APP-110, Page 2 of 5

Trial Court Case Name:

4

(continued)

Trial Court Case Number:

b.

Copy of clerk’s transcript. I request a copy of the clerk’s transcript. (Check and complete (1) or (2).)

(1)

(2)

(a)

(b)

I will pay the trial court clerk for this transcript myself when I receive the clerk’s estimate of the costs of 
the transcript. 

I am asking that a copy of the clerk’s transcript be provided at no cost to me because I cannot afford to 
pay this cost. I have submitted the following document with this notice designating the record (check (a) 
or (b) and submit the checked document):

An order granting a waiver of the cost under rules 3.50–3.58 and 8.818(d).

An application for a waiver of court fees and costs under rules 3.50–3.58 and 8.818(d). (Use Request 
to Waive Court Fees (form FW-001). The court will review this form to decide if you are eligible for 
a fee waiver.) 

Record of Oral Proceedings in the Trial Court

5

The appellant elected to use the following record of what was said in the trial court proceedings (check and   
complete only one of the following below—a, b, or c):  

a.

Reporter’s Transcript. The appellant elected to use a reporter’s transcript under rule 8.834 as the  record of 
the oral proceedings in the trial court.

(1)

Designation of additional proceedings to be included in the reporter’s transcript. (If you want any 
proceedings in addition to the proceedings designated by the appellant to be included in the reporter’s 
transcript, you must identify those proceedings here.)

In addition to the proceedings designated by the appellant, I request that the following proceedings in the 
trial court be included in the reporter’s transcript. (You must identify each proceeding you want included 
by its date, the department in which it took place, a description of the proceedings (for example, the 
examination of jurors, motions before trial, the taking of testimony, or the giving of jury instructions), 
the name of the court reporter who recorded the proceedings, and whether a certified transcript of the 
designated proceeding was previously prepared.)

 Date

Department

Description

Reporter’s Name

(a)

(b)

(c)

(d)

(e)

(f)

(g)

Prev. prepared?
No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

No

Check here if you need more space to list other proceedings and attach a separate page or pages 
listing those proceedings. At the top of each page, write “APP-110, item 5a(1).”

Revised January 1, 2019 

Respondent's Notice Designating Record on Appeal 
(Limited Civil Case)

APP-110, Page 3 of 5

(i)

(ii)

(b)

(a)

(b)

(c)

Trial Court Case Number:

Trial Court Case Name:

5

a.

(continued)
(2)

Copy of reporter’s transcript. I request a copy of the reporter’s transcript.

Certified transcripts. I have attached to this Respondent’s Notice Designating Record on Appeal an 
original certified transcript of all the proceedings I have designated in (1). The transcript complies with 
the format requirements in rule 8.144 of the California Rules of Court.

(3)

Copy of reporter’s transcript. I request a copy of the reporter’s transcript. (Check and complete (a) or 
(b).)

(a)

I will pay for the reporter’s transcript. Within 10 days of receiving the reporter’s estimate of the cost 
of the transcript, I will (check and complete (i) or (ii)):

Deposit an amount equal to the estimated cost of the transcript with the trial court, and a fee of 
$50 for the trial court to hold this deposit in trust. I understand that if I do not comply with this 
requirement, I will not receive a copy of the transcript.  

Pay the reporter directly and file with the trial court a copy of the written waiver of deposit 
signed by the reporter. I understand that if I do not comply with this requirement, I will not 
receive a copy of the transcript.

I am unable to afford the cost of the reporter’s transcript and am therefore applying to the Transcript 
Reimbursement Fund to pay for this transcript. Within 10 days of receiving the reporter’s estimate of 
the cost of the transcript, I will file with the trial court a copy of my application to the Court 
Reporters Board for payment or reimbursement from the Transcript Reimbursement Fund. I 
understand that within 90 days of filing my application, I must file with the trial court a copy of the 
provisional approval of my application or pay for the reporter's transcript as provided in (a). I 
understand that if I do not comply, I will not receive a copy of the transcript.

(4) Format of reporter’s transcript. I request that the reporter provide my copy of the transcript in:

Electronic format only.

Paper format only.

Electronic format and a second copy of the reporter's transcript in paper format.

OR

b.

(1)

Transcript From Official Electronic Recording. The appellant elected to use the transcript from an official 
electronic recording as the record of the oral proceedings in the trial court under rule 8.835(b). 

Designation of additional proceedings to be included in the transcript. (If you want any proceedings 
in addition to the proceedings designated by the appellant to be included in the transcript, you must 
identify those proceedings here.)

In addition to the proceedings designated by the appellant, I request that the following proceedings in the 
trial court be included in the transcript. (You must identify each proceeding you want included by its date, 
the department in which it took place, a description of the proceedings, and if you know it, the name of the 
electronic recording monitor who recorded the proceedings.)

Revised January 1, 2019

Respondent's Notice Designating Record on Appeal 
(Limited Civil Case)

APP-110, Page 4 of 5

Trial Court Case Name:

5

b.

(1)

(continued)

Trial Court Case Number:

 Date

Department

Description

Electronic Monitor’s Name

(a)

(b)

(c)

(a)

(b)

(i)

(ii)

Check here if you need more space to describe any proceeding or to list other proceedings and 
attach a separate page describing or listing those proceedings. At the top of each page, write 
“APP-110, item 5b(1).”

(2)

Copy of the transcript from an official electronic recording. I request a copy of this transcript. (Check 
and complete (a) or (b).)

I will pay the trial court clerk for this transcript myself when I receive the clerk’s estimate of the cost 
of the transcript. I understand that if I do not pay for the transcript, I will not receive a copy.  

I am asking that the transcript be provided at no cost to me because I cannot afford to pay this cost. I 
have submitted the following document with this notice designating the record. (Check (i) or (ii) and 
submit the appropriate document):

An order granting a waiver of the cost under rules 3.50–3.58 and 8.818(d).

An application for a waiver of court fees and costs under rules 3.50–3.58 and 8.818(d). (Use 
Request to Waive Court Fees (form FW-001). The court will review this form to decide if you 
are eligible for a fee waiver.)

c.

OR
Copy of Official Electronic Recording. The appellant and I have agreed to use the official electronic  
recording itself as the record of the oral proceedings in the trial court under rule 8.835(a). I request a copy of 
this recording. (Check and complete (1) or (2).) 

(1)

(2)

(a)

(b)

I will pay the trial court clerk for this copy of the recording myself when I receive the clerk’s estimate of 
the costs of this copy. 

I am asking that the transcript be provided at no cost to me because I cannot afford to pay this cost. I 
have submitted the following document with this notice designating the record. (Check (a) or (b) and 
submit the appropriate document):

An order granting a waiver of the cost under rules 3.50–3.58 and 8.818(d).

An application for a waiver of court fees and costs under rules 3.50–3.58 and 8.818(d). (Use Request 
to Waive Court Fees (form FW-001). The court will review this form to decide if you are eligible for 
a fee waiver.)

Date:

Type or print your name

Signature of respondent or attorney

Revised January 1, 2019

Respondent's Notice Designating Record on Appeal 
(Limited Civil Case)

APP-110, Page 5 of 5