Docketing Statement Template

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UNITED STATES COURT OF APPEALS
FOR THE TENTH CIRCUIT
DOCKETING STATEMENT
Case Name: _____________________________________________________________
Appeal No. (if available) :
_________________________________________________
Court/Agency Appeal From:
________________________________________________
Court/Agency Docket No.: __________________District Judge: _____________________
Party or Parties filing Notice of Appeal/Petition:
_________________________________
______________________________________________________________________
I.
TIMELINESS OF APPEAL OR PETITION FOR REVIEW
A.
APPEAL FROM DISTRICT COURT
1.
Date notice of appeal filed:_________________________________
a.
Was a motion filed for an extension of time to file the notice
of appeal? If so, give the filing date of the motion, the date of
any order disposing of the motion, and the deadline for filing
notice of appeal:
_________________________________________________
_________________________________________________
b.
Is the United States or an officer or an agency of the United
States a party to this appeal?
________________________
2.
Authority fixing time limit for filing notice of appeal:
Fed. R. App. 4 (a)(1)(A) ____
Fed. R. App. 4(a)(6) ____
Fed. R. App. 4 (a)(1)(B) ____
Fed. R. App. 4(b)(1) ____
Fed. R. App. 4 (a)(2)
____
Fed. R. App. 4(b)(3) ____
Fed. R. App. 4 (a)(3)
____
Fed. R. App. 4(b)(4) ____
Fed. R. App. 4 (a)(4)
____
Fed. R. App. 4(c)
____
Fed. R. App. 4 (a)(5)
____
Other: ________________________________

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