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Here is the text we could read:

 

[  ] Appellant 
[  ] Attorney for the Appellant and my Utah Bar number is _________ 

In the [  ]  Utah Supreme Court   [  ]  Utah Court of Appeals 

450 South State Street, Salt Lake City, UT 84111 

Docketing Statement – Criminal 
Case (URAP 9(d)) 

_______________________________ 
Appellate Court Case Number 

  _

_____________________________________ 
Appellee 

______________________________ 

Trial Court Case Number 

_____________________________________ 
Appellant     

(1) 

Nature of the appeal. This appeal is from the: 

[  ]  final judgment and sentence 

[  ]  order of restitution 

[  ]  order revoking probation 

(2) 

Important dates.  

o  When was the judgment of the trial court entered? ________________ 

o  When was the Notice of Appeal filed in the trial court? ________________  

o  Did you receive an extension of time under Appellate Rule 4(e) to file the 

Notice of Appeal? 

[  ]  Yes    [  ]  No 

Docketing Statement – Criminal Case 

Approved by the Board of Appellate Court Judges May 27, 2015 

Page 1 of 4 

 
Name 

ddress 

ity, State, Zip 

hone 

mail 
 
I am the 

  A

  C

  P

  E

 

v. 

 

If yes, when was the Motion for an Extension of Time granted? 
________________ 

o  Did you file any of the following motions?  

Motion filed under:  Date motion filed: 

Date of orders ruling on the motion: 

[  ]  Yes    [  ]  No 

URCrP 24 
URAP 4(f) 

 
 

[  ]  Yes    [  ]  No 

o  Are you an inmate confined in an institution? 

 
 

If yes, when was the Notice of Appeal deposited in the institution’s internal 
mail system? ________________ 

(3)   Conviction.  I was convicted of the following crimes (Include the offense and the level 

of the offense. For example, robbery, second degree felony.):  

(4) 

Issues on appeal. Separately describe the issue(s) that you plan to argue in 
your appeal. 

     

             

 (5)  Summary of what happened in the trial court. (Briefly describe the facts relating to 
the issue(s) described above. If the conviction was due to a plea of guilty or no contest, include 
whether you moved to withdraw the plea before sentencing, and whether the plea was 
conditional.) 

Docketing Statement – Criminal Case 

Approved by the Board of Appellate Court Judges May 27, 2015 

Page 2 of 4 

 

 

 

 

             

(6) 

Related appeals. Have there been any appeals in this matter before this 
appeal? Are there any other appeals related to this appeal? 

[  ]  Yes    [  ]  No 

If yes to either question, provide the appellate court case numbers. If the earlier 
or related appeal resulted in a written decision, provide the decision citation, if 
available.  

 

Case Number 

Citation  (For example, 2015 UT 36 or 2015 UT App 103) 

 
 

(7) 

Attachments. 

I have attached a copy of the sentence, judgment and commitment. 

 
Date 

Sign here ► 

 

 

Typed or Printed Name 

 
 

 

Docketing Statement – Criminal Case 

Approved by the Board of Appellate Court Judges May 27, 2015 

Page 3 of 4 

 

 

 

   

 

Certificate of Service 

I certify that on ____________________ (date) a copy of this Docketing Statement was 
served on all parties listed here by the method indicated below: 

Mailed  Emailed  Hand-delivered  Name 

  Mailing or Email Address 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

[  ] 

 

 

 

 

 

 

 

 

 

 

 

 

Date 

Typed or Printed Name 

Sign here ► 

 

 

Docketing Statement – Criminal Case 

Approved by the Board of Appellate Court Judges May 27, 2015 

Page 4 of 4

Docketing Statement – Criminal Case (URAP 9(d))

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Utah state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from legacy.utcourts.gov (2023-03)
Page(s): 4
Fields(s): 94
Average fields per page: 23
Reading Level: Grade 8
LIST Grouping(s): Unknown

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

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page_field__1 was page_0_field_9 (0.31 conf)
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appellant was appellant (0.46 conf)
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page_check__6 was page_1_check_1 (0.26 conf)
page_check__7 was page_1_check_2 (0.26 conf)
page_check__8 was page_1_check_3 (0.26 conf)
related_appeals_matter was related_appeals__have_there_been_any_appeals_in_this_matter_before_this (0.43 conf)
users1_signature was sign_here (1.00 conf)
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page_check__11 was page_3_check_0 (0.33 conf)
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page_check__14 was page_3_check_3 (0.26 conf)
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page_check__16 was page_3_check_5 (0.26 conf)
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page_check__18 was page_3_check_7 (0.26 conf)
page_check__19 was page_3_check_8 (0.26 conf)
page_check__20 was page_3_check_9 (0.26 conf)
page_check__21 was page_3_check_10 (0.26 conf)
page_check__22 was page_3_check_11 (0.26 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Docketing Statement – Criminal Case (URAP 9(d))

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02