UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF IOWA
Notice of Appeal Supplement
Case Name: _____________________________ vs. ___________________________________
District Court Case Number: ______________________________________________________
Appeal Fee (505.00) Status: Pd ____ IFP ____ Pending ____ Government Appeal ____
Counsel: Appointed ____ CJA ____ Retained ____ Pro Se ____ Pro Bono ____
*Reminder: CJA appointed counsel will need to complete their AUTH 24 form thru CJA eVoucher.
Appeal filed by: Counsel ____ Pro Se ____
Any reason why counsel should not be appointed: ______________________________________
Certificate of Appealability: Denied ____ Granted ____ Not Issue ____
Pending post Judgment motions: Yes ____ No ____
If so, type of motion(s) and docket entry number:
______________________________________________________________________________
High Public Interest Case: Yes ____ No ____
Simultaneous Opinion release Requested: Yes ____ No ____
Trial Held: Bench ____ Jury ____ No ____
Court Reporter: Yes ____ No ____
Reporter’s Name: _______________________________________________________________
Appealing: Order prior to final judgment ___ or final judgment ____
***File this form with the Notice of Appeal***
Case 4:21-cv-00264-RP-HCA Document 62 Filed 10/08/21 Page 1 of 1
The Arc of Iowa et al
Reynolds et al
4:21-cv-00264-RP-HCA
Tonya Gerke 515-284-6444 Delayne Johnson 515-224-1166