80000005 052017Page 1of 1Vermont SupremeCourt109 State StreetMontpelier VT 0560908018028284774wwwvermontjudiciaryorgNOTICE OF APPEALVermont Rules of Appellate ProcedureVRAP3and4IN THE SUPREME CO ID: 894567
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1 800 - 00005 - Notice of Appeal ( 05/201
800 - 00005 - Notice of Appeal ( 05/2017 ) Page 1 of 1 Vermont Supreme Court 109 State Street Montpelier , VT 05 609 - 0801 802 - 828 - 4774 www.vermontjudiciary.org NOTICE OF APPEAL Vermont Rules of Appellate Procedure (V.R.A.P.) 3 and 4 IN THE SUPREME COURT OF THE STATE OF VERMONT For Superior Court A ppeals: UNIT : DIVISION : For Board or Agency A ppeals: BOARD OR AGENCY NAME: For A ll A ppeals: CA SE NAME : DOCKET NUMBER : Notice is given that ___________ ___________ ___ ______ _, ______________________ , appeals to ( n ame of party appealing) (Plaintiff/Defendant) the Supreme Court from _________ ______________________________ ______________ ____________ ___ (describ e order being appeal ed ) entered on the _______ day of ____ ___________________________, 20 __ __ _. Signature: ______ _______________ _____ ______ Date: _______________________ Name : Mailing a ddress : P hone : Email address : Attorney for : NOTE : This form must be filed with the superior court clerk or administrative agency and a copy sent to the Supreme Court docket clerk, counsel of record for each represented party, and any self - represented party. V.R.A.P. 3(b). The form may be used for any appeal to the Supreme Court, whether from the superior court or an administrative agency.