Supreme Court of Appeals of West Virginia
Docketing Statement
INSTRUCTIONS:
1. A docketing statement must be filed for every civil and criminal case appealed to the Supreme Court
of Appeals. A docketing statement is not required for petitions for appeal from administrative
tribunals, petitions for certified question review, petitions for post-conviction bail, or petitions for
original jurisdiction relief.
2. The docketing statement must be attached to the original and each copy of the petition for appeal,
including those served upon opposing counsel or parties unrepresented by counsel. The docketing
statement must be in the form approved by the Supreme Court of Appeals or in a substantially similar
form. Abbreviations may be used in the case style portion of the docketing statement.
3. The attorney filing the petition for appeal is responsible for filing the docketing statement, even if
different counsel will handle the appeal.
4. Only one docketing statement shall be filed for each petition for appeal. In the case of multiple
petitioners joining in one petition for appeal, the parties should confer and decide who will file the
docketing statement.
5. The nature of proceedings and relief sought should be stated summarily. The docketing statement is
not a brief and should not contain argument or motions. The issues should be expressed in terms and
circumstances of the case but without unnecessary detail. Conclusory statements such as "the
judgment of the trial court is not supported by the law or facts" are unacceptable.
6. Counsel or parties unrepresented by counsel should make every effort to include in the docketing
statement all of the issues to be presented to the Supreme Court of Appeals. Failure to include all
issues or the manner of presenting issues in the docketing statement, however, will not affect the
jurisdiction of the Supreme Court of Appeals to consider the issues as presented in the petition.
7. If a respondent concludes that the docketing statement is inaccurate or incomplete, such inaccuracies
or omissions should be addressed in the response to the petition for appeal.
WEBFORM INSTRUCTIONS: Click in the appropriate text fields to complete the form, using carriage returns as
necessary. Use the “TAB” key to move between fields. When completed, use the print button or menu item in your
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Supreme Court of Appeals of West Virginia
DOCKETING STATEMENT
Style of Case ( use style from final order) Type of Action:
Civil
Criminal
Petitioner(s):
Plaintiff(s)
Defendant(s)
Circuit Judge: Number:
Circuit
County:
TIMELINESS OF APPEAL
Date of entry of judgment or order appealed from:
Filing date of any post-judgment motion filed by any party
pursuant to R. Civ. P. 50(b), 52(b), or 59:
Date of entry of order deciding post-judgment motion:
Date of filing of petition for appeal:
Date of entry of order extending appeal period:
Time extended to:
FINALITY OF ORDER OR JUDGMENT
Is the order or judgment appealed from a final decision on the merits as to all issues and parties?
YES NO
If no, was the order or judgment entered pursuant to R. Civ. P. 54(b)?
YES NO N/A
Has the defendant been convicted? YES NO N/A
Has a sentence been imposed? YES NO N/A
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Is the defendant incarcerated? YES NO N/A
Has this case previously been appealed? YES NO
If yes, give the case name, docket number, and disposition of each prior appeal on a separate sheet.
Are there any related cases currently pending in the Supreme Court of Appeals or Circuit Court?
YES NO
If yes, cite the case and the manner in which it is related on a separate sheet.
CASE INFORMATION
State generally the nature of the suit, the relief sought, and the outcome below. [Attach an additional
sheet, if necessary.]
State the issues to be raised on appeal. [Attach an additional sheet, if necessary. Use carriage returns
to number the issues in a manner corresponding with the petition for appeal.]
Enter text here. Use carriage returns as necessary. Select and delete this text before continuing. Use "TAB" to move
between fields in the form.
Continued: State the issues to be raised on appeal. [Attach an additional sheet, if necessary. Use
carriage returns to number the issues in a manner corresponding with the petition for appeal.]
CASE MANAGEMENT INFORMATION
Do you wish to make an oral presentation of the petition? YES NO
Has the entire or only portions of the record been designated? ENTIRE PORTION
If the appeal is granted,do you desire reproduction of the record REPRODUCED
or that the case be heard on the original record? ORIGINAL
List counsel for each adverse party to the appeal. Include name, firm name, address, and telephone
number. If unrepresented by counsel, provide the address and telephone number of the adverse
party. Attach an additional sheet if necessary.
Enter text here. Use carriage returns as necessary. Select and delete this text before continuing. Use "TAB" to move
between fields in the form.
Enter text here. Use carriage returns as necessary. Select and delete this text before continuing. Use "TAB" to move
between fields in the form.
List the Petitioner(s) name:
If incarcerated, provide institutional address:
Name of attorney or pro se litigant filing Docketing Statement:
ATTORNEY PRO SE
Will you be handling the appeal? YES NO
If so, provide firm name, address, and telephone number:
If this is a joint statement by multiple petitioners, add the names and addresses of the other petitioners
and counsel joining in this Docketing Statement on an additional sheet, accompanied by a
certification that all petitioners concur in this filing.
Signature: _________________________________
WV Bar No. _______________________________
Date: _____________________________________
Remember to Attach:
1. Additional pages, if any, containing extended answers to questions on this form.
2. A copy of the order or judgment from which the appeal is taken.
3. A Certificate of Service.
Enter name here. Delete this text first.
Enter name here. Delete this text first.