notice of appeal from a decision of the vermont judicial …

500-00420 – Notice of Appeal from a Decision (03/2019) Page 1 of 1 Vermont Judicial Bureau PO Box 607 White River Junction, VT 05001 Phone: 802-295-8869 www.vermontjudiciary.org [email protected] NOTICE OF APPEAL FROM A DECISION OF THE VERMONT JUDICIAL BUREAU A decision of the hearing officer may be appealed to the Criminal Division of the Superior Court. The proceeding before the Criminal Division of the Superior Court shall be on the record, or at the option of the defendant, de novo. The defendant shall have the right to trial by jury. An appeal shall stay payment of a penalty and the imposition of points. – 4 V.S.A. § 1107(a). Case Information County: ______________________________________ Docket (Complaint) Number: ______________________________________ Plaintiff (State of Vermont or municipality): ______________________________________ Defendant’s Name: ______________________________________ Date of Decision: ______________________________________ Party Filing the Appeal (Appellant) Appellant’s Name: ______________________________________ Appellant’s Address: ______________________________________ ______________________________________ ______________________________________ Appellant’s Phone Number: ______________________________________ DEFENDANT* to choose: ☐ Appeal on the Record (meaning that neither party may present new evidence) OR ☐ De Novo Appeal (where evidence is again presented for the Court to consider) If de novo ☐ by judge OR ☐ by jury * See 4 V.S.A. § 1107(a) Date: ________________ Signature: _______________________________ If Appellant is under the age of 18: Name of Parent or Guardian: ______________________________________ Signature of Parent or Guardian: ______________________________________ This form and appropriate filing fee must be filed with the Vermont Judicial Bureau within 30 days of the issuance of the decision being appealed.

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Page 1: NOTICE OF APPEAL FROM A DECISION OF THE VERMONT JUDICIAL …

500-00420 – Notice of Appeal from a Decision (03/2019) Page 1 of 1

Vermont Judicial Bureau PO Box 607 White River Junction, VT 05001

Phone: 802-295-8869www.vermontjudiciary.org

[email protected]

NOTICE OF APPEAL FROM A DECISION OF THE VERMONT JUDICIAL BUREAU

A decision of the hearing officer may be appealed to the Criminal Division of the Superior Court. The proceeding before the Criminal Division of the Superior Court shall be on the record, or at the option of the defendant, de novo. The defendant shall have the right to trial by jury. An appeal shall stay payment of a penalty and the imposition of points. – 4 V.S.A. § 1107(a).

Case Information

County: ______________________________________ Docket (Complaint) Number: ______________________________________ Plaintiff (State of Vermont or municipality): ______________________________________ Defendant’s Name: ______________________________________ Date of Decision: ______________________________________

Party Filing the Appeal (Appellant) Appellant’s Name: ______________________________________ Appellant’s Address: ______________________________________

______________________________________ ______________________________________

Appellant’s Phone Number: ______________________________________

DEFENDANT* to choose:

☐ Appeal on the Record (meaning that neither party may present new evidence)

☐ De Novo Appeal (where evidence is again presented for the Court to consider)

If de novo

☐ by judgeOR

☐ by jury* See 4 V.S.A. § 1107(a)

Date: ________________ Signature: _______________________________

If Appellant is under the age of 18: Name of Parent or Guardian: ______________________________________ Signature of Parent or Guardian: ______________________________________

This form and appropriate filing fee must be filed with the Vermont Judicial Bureau within 30 days of the issuance of the decision being appealed.

http://www.vermontjudiciary.org/

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