UNITED STATES DISTRICT COURT FOR THE SOUTHERN

DISTRICT OF FLORIDA

CASE NO: *

UNITED STATES OF AMERICA,

Plaintiff,

vs.

*,

Defendant.

/

NOTICE OF APPEAL

Notice is hereby given that *, defendant in the above named case, hereby appeals to the United States Court of Appeals for the Eleventh Circuit from the final judgment and sentence entered in this action on the * day of *, 200*.

Respectfully submitted,

ATTORNEY

*

Florida Bar No. *

ADDRESS

CITY, STATE ZIP

Telephone:

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing instrument was served by U.S. mail this * day of *, 200*, upon *, Assistant United States Attorney, Chief of Appellate Division, 99 N.E. 4th Street, Miami, Florida 33132.

UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT

Appearance of Counsel Form

TO ENTER AN APPEARANCE, PLEASE COMPLETE AND RETURN THIS FORM WITHIN 14 DAYS.

YOU MAY NOT RECEIVE FURTHER NOTICE OF PROCEEDINGS ON APPEAL UNLESS THIS FORM IS TIMELY FILED.

Please Type or Print	No.

United States of America	vs. *

The Clerk will enter my appearance for these named parties: *

X appellant(s)	□ petitioner(s)	□ intervenor(s)

In this court these parties are:

□ appellee(s)	□ respondent(s)	□ amicus curiae

□ The following related or similar cases are pending on the docket of this court:

X This appeal is entitled to preference for the following reason(s):

This is an appeal in a criminal case. Fed. R. App. P. 45(b).

X Check here if you are court-appointed counsel.

Signature:	Soc. Sec. No.: *

Name (Type or Print):

Firm/Govt. Office:	Phone:

Street Address:

City:	State:

To enter an appearance, you must be an 11th Circuit bar member, seek admission (form below), or be exempt under 11th Cir. R. 46-1(a) [see reverse]

UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT

Application for Admission to the Bar

VERIFIED PERSONAL STATEMENT:

PART I. (Please Type or Print)

Name:	Social Sec. No.:

(As you want it to appear on certificate)

Firm Name:	Your Birthdate:

Address:

Suite No. Street Address

Business Phone: ( )

City State Zip

Pursuant to Fed.R.App.P.46(a), to qualify for admission you must be a member in good standing of the bar of the U.S. Supreme Court, another U.S. Court of Appeal, a U.S. District Court or the highest court of any state. Please specify which court qualifies you for admission:

Qualifying Court:	Date Admitted:

PART II. (Answer each question. If any answer is yes, attach a statement giving details.)

YES NO

1.	Have you changed your name or been known by any names or surnames other than the one appearing on the application?

2a.	Have you been disbarred or suspended from practice before any court, department, bureau or commission of any State or the

United States, or have you received a reprimand from any of them pertaining to your conduct or fitness to practice?

2b.	Are any such proceedings or allegations presently pending against you?

3a.	Have you been a party to criminal proceedings, or to civil proceedings in which allegations of fraud, misrepresentation or

other dishonesty were made against you?

3b.	Are you presently under investigation for any matter specified in question 3a?

(Reverse Side Must Also Be Completed In Full)