Notice Of Appeal And Request For Trial De Novo
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IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE THIRD JUDICIAL DISTRICT
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________________________________,
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NOTICE OF APPEAL FROM
Plaintiff/Petitioner,
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ARBITRATION AWARD AND
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REQUEST FOR TRIAL DE NOVO
vs.
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Case No. _____________________
________________________________,
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Defendant/Respondent.
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Plaintiff
Defendant hereby gives notice of appeal from the arbitration award filed in this
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case on ___________________________ and requests a trial de novo on all issues of law and fact.
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_____________________________________
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Signature of Plaintiff/Defendant
Submitted by:
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______________________________________
______________________________________
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Plaintiff/Defendant, Pro Se (print name)
City, State, Zip Code
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______________________________________
______________________________________
Address
Telephone
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Certificate of Document Preparation
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You are required to truthfully complete this certificate regarding the document(s) you are filing with
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the court. Check or complete all blanks that apply. I certify that:
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I selected the document(s) for myself.
I was provided the document(s) by an attorney.
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I completed the documents without paid assistance.
I paid or will pay money to ____________________________ for assistance in preparing
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the document(s)/form(s).
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________________
__________________________________
Dated
Signature
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28 NOTICE OF APPEAL AND REQUEST FOR TRIAL DE NOVO - Page 1 of 1
FC (6/12/03)
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