Notice And Grounds Of Appeal Or Application For Permission To Appeal Against Conviction Or Sentence To The Court Of Appeal (Criminal Division)

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FOR OFFICIAL USE -
CAO No.
/
/
Form
NG
NOTICE and GROUNDS of appeal or application for permission to
appeal against conviction or sentence to THE COURT OF APPEAL
CRIMINAL DIVISION (Criminal Procedure Rules, rr 68.3(1),(2))
Please ensure that you have read the notes for guidance attached before completing this form. Write in
BLACK INK and use BLOCK CAPITALS
The Appellant
Surname
_________________________
Prison Index No __________________
Forenames _________________________
_________________________
Prison __________________________
__________________________
Address
_________________________
__________________________
_________________________
__________________________
(if not in
_________________________
custody)
postcode
_________________________
Date of birth _____________________
The Court
The Crown Court at _________________
Name of Judge
___________________
where tried
Or sentenced
Date Trial started
_________________
Date of conviction ___________________
Date of sentence
_____________________________________________________
Total period of remand in custody prior to sentence ____________________________
The
Conviction(s)
Crown Court
Count No.
Offence(s)
Sentence
and/or
Case number(s)
sentence(s)
Total
sentence
Applications
Extension of time in which to make any of the following application(s)
The appellant
(not to be applied for separately – see Note 7))
is applying for:
Permission to appeal against conviction
Representation Order
Please tick (√)
as appropriate
Bail
Permission to appeal against sentence
Please also see
the attached
Permission to appeal against a confiscation order
Permission to call
guidance notes
witness
1

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