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This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Appellate Courts.
Instructions
THIS APPEAL INVOLVES A MATTER SUBJECT TO EXPEDITED DISPOSITION UNDER
RULE 311(a).
Appellate Case No.:
APPEAL TO THE APPELLATE
COURT OF ILLINOIS,
District
FROM THE CIRCUIT COURT OF
County
Check the box to the
right if your case
involves parental
responsibility or
parenting time
(custody/visitation
rights) or relocation of
a child.
Enter the appellate
court case number if
you have it.
In the space below
"Appeal to the
Appellate Court of
Illinois," enter the
number of the
appellate district
where you are filing
the appeal and the
county of the trial
court.
In re
Plaintiffs/Petitioners (First, middle, last names):
Appellant
Appellee
v.
Defendants/Respondents (First, middle, last names):
Appellant
Appellee
Trial Court Case No.:
Honorable
Judge, Presiding
If the case name in the
trial court began with
"In re" (for example,
"In re Marriage of
Jones"), enter that
phrase. If the case
name did not begin
with "In re," enter the
names of the parties as
they appeared in the
trial court documents.
Below each party
name, check either
Appellant if the party
filed the appeal or
Appellee if the party
is responding to the
appeal.
To the far right, enter
the trial court case
number and trial
judge's name.
In 1, enter your name.
If trial exhibits are
important to your
appeal, you need to
make sure the trial
court clerk has them
before the record is
prepared. Be sure to
read How to Order the
Record on Appeal.
If you are completing
this form on a
computer, sign your
name by typing it. If
you are completing it
by hand, sign by hand
and print your name.
Enter your complete
current address,
telephone number, and
email, if you have one.
REQUEST FOR PREPARATION OF RECORD ON APPEAL
1.
Notice is hereby given to the trial court clerk that:
First
Middle
Last
requests the preparation of the Record on Appeal in the above case.
2.
I request that the trial court clerk prepare the Record on Appeal in accordance with Illinois
Supreme Court Rule 321. I request that the Record on Appeal include all documents filed, all
judgments and orders entered, all documentary exhibits entered at trial, and all Reports of
proceedings prepared in accordance with Illinois Supreme Court Rule 323.
/s/
Your Signature
Street Address
Print Your Name
City, State, ZIP
Email
Telephone
Attorney # (if any)
PRA- R 4303.3
Page 1 of 1
(07/21)
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Completed 1 July 2022

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