600-00029 -Notice of Appeal (05/2017) Page 1 of 1
STATE OF VERMONT
SUPERIOR COURT
Docket No.
NOTICE OF APPEAL
DOCKET NUMBER:
Notice is given that _________________________________________, ______________________, appeals to
(name of party appealing) (Plaintiff/Defendant)
the Superior Court from ____________________________________________________________________
(describe order being appealed)
entered on the _______ day of _______________________________, 20_____.
Signature: __________________________________________________________
Name: ____________________________________________________
Mailing address: ____________________________________________________
Phone: ____________________________________________________
Email address: ____________________________________________________
Attorney for: ____________________________________________________
NOTE: This form must be filed with the court clerk and a copy sent to the Superior Court docket clerk, counsel of
record for each represented party, and any self-represented party. V.R.A.P. 3(b)