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This form is approved by the Illinois Supreme (Microsoft)

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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).
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.
Just below "Appeal to
the Appellate Court of
Illinois," enter the
number of the
appellate district that
will hear the appeal
and the county of the
trial court.
In re
Plaintiffs/Petitioners (First, middle, last names)
Appellants
Appellees
v.
Defendants/Respondents (First, middle, last names)
Honorable
If the case name in the
trial court began with
“In re” (for example,
“In re Marriage of
Jones”), enter that
name. Below that,
enter the names of the
parties in the trial
court, and check the
correct boxes to show
which party is filing
the appeal
(“appellant”) and
which party is
responding to the
appeal (“appellee”).
To the far right, enter
the trial court case
number, the trial
Appellants
Appellees
judge's name, and the
Supreme Court Rule
that allows the
appellate court to hear
the appeal.
In 1, check the type of
appeal.
For more information
on choosing a type of
appeal, see How to File
a Notice of Appeal.
In 2, list the name of
each person filing the
appeal and check the
proper box for each
person.
NOTICE OF APPEAL
1.
Type of Appeal:
Appeal
Interlocutory Appeal
Joining Prior Appeal
Separate Appeal
Cross Appeal
2.
Name of Each Person Appealing:
Name:
First
Middle
Last
Plaintiff-Appellant
Petitioner-Appellant
OR
Defendant-Appellant
Respondent-Appellant
NAA-N 2803.5
Page 1 of 4
(07/21)
I
Name:
In 3, identify every
order or judgment you
want to appeal by
listing the date the trial
court entered it.
3.
First
Middle
Last
Plaintiff-Appellant
Petitioner-Appellant
OR
Defendant-Appellant
Respondent-Appellant
List the date of every order or judgment you want to appeal:
Date
Date
In 4, state what you
want the appellate
court to do. You may
check as many boxes
as apply.
4.
Date
State your relief:
reverse the trial court's judgment (change the judgment in favor of the other party into a
judgment in your favor) and
send the case back to the trial court for any hearings
that are still required;
vacate the trial court's judgment (erase the judgment in favor of the other party)
and
send the case back to the trial court for a new hearing and a new judgment;
change the trial court's judgment to say:
order the trial court to:
other:
and grant any other relief that the court finds appropriate.
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. Fill in your
address, telephone
number, and email
address, if you have
one.
/s/
Your Signature
Street Address
Your Name
City, State, ZIP
Email
Telephone
Attorney # (if any)
Additional Appellant Signature
/s/
Signature
Street Address
Name
City, State, ZIP
Email
Telephone
Attorney # (if any)
All appellants must
sign this form. Have
each additional
appellant sign the form
here and enter their
complete name,
address, telephone
number, and email
address, if they have
one.
GETTING COURT DOCUMENTS BY EMAIL: You should use an email account that you do not share with anyone else and that you check
every day. If you do not check your email every day, you may miss important information, notice of court dates, or documents from other parties.
.
NAA-N 2803.5
Page 2 of 4
(07/21)
In 1a, enter the name,
mailing address, and
email address of the
party or lawyer to
whom you sent the
document.
In 1b, check the box to
show how you sent the
document, and fill in
any other information
required on the blank
lines.
In 1b, check the box to
show how you are
sending the document.
CAUTION: If you and
the person you are
sending the document
to have an email
address, you must use
one of the first two
options. Otherwise,
you may use one of the
other options.
In c, fill in the date and
time that you sent the
document.
In 2, if you sent the
document to more
than 1 party or lawyer,
fill in a, b, and c.
Otherwise leave 2
blank.
PROOF OF SERVICE (You must serve the other party and complete this section)
1.
I sent this document:
a.
To:
Name:
First
Middle
Last
Address:
Street, Apt #
City
State
ZIP
Email address:
b.
By:
An approved electronic filing service provider (EFSP)
Email (not through an EFSP)
Only use one of the methods below if you do not have an email address, or the person you are
sending the document to does not have an email address.
Personal hand delivery to:
The party
The party’s family member who is 13 or older, at the party’s residence
The party’s lawyer
The party’s lawyer’s office
Mail or third-party carrier
c.
On:
Date
At:
a.m.
p.m.
Time
2.
I sent this document:
a.
To:
Name:
First
Middle
Last
Address:
Street, Apt #
City
State
ZIP
Email address:
b.
By:
An approved electronic filing service provider (EFSP)
Email
(not through an EFSP)
Only use one of the methods below if you do not have an email address, or the person you are
sending the document to does not have an email address.
Personal hand delivery to:
The party
The party’s family member who is 13 or older, at the party’s residence
The party’s lawyer
The party’s lawyer’s office
Mail or third-party carrier
c.
On:
Date
At:
a.m.
p.m.
Time
.
NAA-N 2803.5
Page 3 of 4
(07/21)
In 3, if you sent the
document to more than
1 party or lawyer, fill
in a, b, and c.
Otherwise leave 2
blank.
3.
I sent this document:
a.
To:
Name:
First
Middle
Last
Address:
Street, Apt #
City
State
ZIP
Email address:
Under the Code of
Civil Procedure, 735
ILCS 5/1-109
,
making a statement
on this form that you
know to be false is
perjury, a Class 3
Felony.
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.
b.
By:
An approved electronic filing service provider (EFSP)
Email (not through an EFSP)
Only use one of the methods below if you do not have an email address, or the person you are
sending the document to does not have an email address.
Personal hand delivery to:
The party
The party’s family member who is 13 or older, at the party’s residence
The party’s lawyer
The party’s lawyer’s office
Mail or third-party carrier
c.
On:
Date
At:
a.m.
p.m.
Time
I certify that everything in the Proof of Service is true and correct. I understand that making
a false statement on this form is perjury and has penalties provided by law
under 735 ILCS 5/1-109.
/s/
Your Signature
Print Your Name
Attorney # (if any)
.
NAA-N 2803.5
Page 4 of 4
(07/21)
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Completed 1 July 2022

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