Phone No.

ELEVENTH CIRCUIT TRANSCRIPT INFORMATION FORM

Appellant to complete andfile with the District Court Clerk within 10 days of the filing of the notice of appeal in all cases, including

those in which there wa no hearing or for which no transcript is ordered.

I.

Short Case

Distnct Court No/p Notice of Appeal Filed:Wf_ Court of Appeals No.: _________

/ /

(If Available)

CHOOSE ONE: 0 No hearing otranscript is reuir4 foE appea' purposes 0 All necessary transcript(s) on file

01 AM ORDERING A TRANSCRIPT OF THE FOLLOWING PROCEEDINGS:

Check appropriate box('es,) and provide all infonnnquste,d fl: 53

HEARING DATEfS DGE/MAGISTRATE, cOURT REPORTER Ni.ME()

0 Pre-Trial Proceedings

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U]

3 • I (I),JI)i Ji'd I 3K

o I CERTIFY THAT I HAVE CONTACTED THE COURT REPORTER(S) AND HAVE MADE SATISFACTORY ARRANGEMENTS

WITH THE COURT REPORTER(S) FOR PAYING THE COST OF THE TRANSCRIPT.

0 CRIMINAL JUSTICE ACT. Attached for submission to District Judge/Magistrate is my completed CJA Form 24 requesting authorization

for government payment of transcript. [A transcript of the following proceedings will be provided ONLY IF SPECIFICALLY AUTHORIZED in

Item 13 on CJA Form 24: Voir Dire; Opening and Closing Statements of Prosecution and Defense; Prosecution Rebuttal; Jury Instructions.]

Ordering Counsel/Party:

Name of Firm:

Street Address/P.O. Box:

City/State/Zip Cede:

I cert/' that I have filed the original (Yellow page) with the District Court Clerk sent the Pink and Green pages to the appropriate Court

Reporter(s) f ordering a transcript, and n a photocopy to he Court ofAppeals Clerk and to al/parties.

DATI1Attorney for:_________________

PART II. COURT REPORTER ACKNOWLEDGMENT

Court Reporter to complete andfile Pink page with the District Court Clerk within 10 days of receipt. The Court Reporter shall send a

photocopy to the Court ofAppeals Clerk and to all parties, and retain the Green page to provide not/ication when transcript filed.

Date Transcript Order received:__________________

o Satisfactory arrangements for paying the cost of the transcript were completed on:____________________

o Satisfactory arrangements for paying the cost of the transcript have not been made.

No. of hearing days:__________ Estimated no. of transcript pages:___________ Estimated filing date:_______________

DATE:____________ SIGNED:________________________________ Phone No.:__________________

NOTE: The transcript is due to be filed within 30 days of the date satisfactory arrangements for paying the cost of the transcript

were completed unless the Court Reporter obtains an extension of time to file the transcript.

PART ifi. NOTiFICATION THAT TRANSCRIPT HAS BEEN FILED IN DISTRICT COURT

Court Reporter to complete andfile Green page with the District Court Clerk on date offihing transcript in District Court. The Court

Reporter shall send a photocopy of the completed Green page to the Court ofAppeals Clerk on the same date.

This is to certify that the transcript has been completed and filed with the district court on (date):

ActualNo. of Volumes and Hearing Dates:_____________________________________________

Date:___________ Signature of Court Reporter:

U.S GOVERNMENT PRINTING OFFICE: 2005 735-932/39003

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