Form 417a - Notice Of Appeal And Statement Of Election printable pdf download

Form 417a - Notice Of Appeal And Statement Of Election

Official Form 417A (12/15)

[Caption as in Form 416A, 416B, or 416D, as appropriate]

NOTICE OF APPEAL AND STATEMENT OF ELECTION

Part 1: Identify the appellant(s)

1. Name(s) of appellant(s):

_________________________________________________________________________

2. Position of appellant(s) in the adversary proceeding or bankruptcy case that is the subject of this

appeal:

For appeals in an adversary proceeding.

For appeals in a bankruptcy case and not in an

adversary proceeding.



Plaintiff



Defendant

Debtor



Other (describe) ________________________

Creditor



Trustee



Other (describe) ________________________

Part 2: Identify the subject of this appeal

1. Describe the judgment, order, or decree appealed from: ____________________________

2. State the date on which the judgment, order, or decree was entered: ___________________

Part 3: Identify the other parties to the appeal

List the names of all parties to the judgment, order, or decree appealed from and the names, addresses,

and telephone numbers of their attorneys (attach additional pages if necessary):

1. Party: _________________

Attorney: ______________________________

______________________________

2. Party: _________________

Attorney: ______________________________

______________________________

Official Form 417A

Notice of Appeal and Statement of Election

page 1

Form 417a - Notice Of Appeal And Statement Of Election