### TRIAL COURT OFFICIAL'S

REQUEST FOR EXTENSION OF TIME TO FILE RECORD

Court of Appeals No. (If known): 

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Trial Court Style: 

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Date Trial Clerk's Record Originally Due:

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Date Court Reporter's/Recorder's Record Originally Due: 

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Anticipated Number of Pages of Record: 

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am responsible for preparing a record in this appeal but I am unable to file the record by the original due date for

the following reason/s: (Check all that apply

- attach additional pages if necessary.)



# D to the best of my knowledge, the Appellant has made no claim of indigence and has failed to either**~quired** fee or to make arrangements to pay the fee for preparing the record. 

# 0 my duties listed below preclude working on this record:

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hereby request an additional 

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### TEX. R. APP. P. 37.3_. 10\ 

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In compliance with TEX. R. APP. P. 9.5(e), I certify that a copy of this notice has been served on counsel for all

parties to the trial Court's judgment or order being appealed. I further certify by my signature below that the

information contained in this notice is true and within my personal knowledge. 

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## '~~\(\)~~Trial Clerk's/Court Reporter's Request for Ext/12 111 CA-CsL!Tyler/12-3-97 /Rev.5-3-2001

TEXAS RULE OF APPELLATE PROCEDURE 9.5(e) reads:

Certificate requirements. A certificate of service must be signed by the person who made the service

and must state:

(I) the date and manner of service; (2) the name and addresses of each person served; and (3) ifthe person served is a party's attorney, the name of the party represented by that attorney.

The following parties have been served with a copy of this document: (Infonnation may be either printed or typed.)

Lead Counsel for APPELLANT(s):

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Address: 

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Lead Counsel for APPELLA1'T(S):

Address:

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Phone**no.:·-------------~**

Attorney for:.

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Additional information, Lead Counsel for APPELLEE(s):

Name:

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Attorney for:

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Lead Counsel for APPELLEE(S ):

Name:

Address:

Phone no.:

Attorney for:

if any: