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Appellate Docket Number: OSt_ IS— ScfS 7— CE
Appellate Case Style: Jp-i.p, e. 3a.-’ Ii .c*,’efzf— >4mA
Companion
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Case(s): %7 59 cC/ 7 c$OO
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Amended/Corrected Statement
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DOCKETING STATEMENT (Civil) Cowi nf Appeals
Appellate Court: Select JUN 012018
(to be filed in the court of appeals upon perfection of appeal under TRAP 32)
Lisa Matz
NOTE: Becarve spacefor additional parties I attorneys Lc limited on thLvfbnn. you can include the rnfonnation On a seParappçus4h4.u)rthde
32.1 and 9.4. please include party’s ‘lame and the name, address; email address, telephone number, fia number, if any, OIW .)ta e a,’ Numoer of the
partj’’s lead cowmel. Ifthe paw Lc not represented by an attorney, that party :ç name, adthtsw. telephone windier, fax nu,nhershozdd hepmvided.
I. Appellant II. Appellant Attorney(s) Continued-
Person Organization Lead Attorney Select
Name:4S2AceX/ &/chJj%tdn 1Name:
Bar No.
IfPro Se Party, enter thefollowing information Firm Name:
Address: (/ c9 1Ct1If7/E..sj_ c1iI2C_1a Address I:
City/State/Zip: /74o.., /c tf4 77/ Address 2:
Tel.9p79.. ç/pE9%L3”Fax: flcYLt’ City/State/Zip:
Email: 4cne 4 flo Tel. Ext. Fax:
11. Appellant Attorney(s) Email:
Lead Attorney Select Select
Lead Attorney
Name: Name:
Bar No. Bar No.
Firm Name: Firm Name:
Address 1: Address I:
Address 2: Address 2:
City/State/Zip: City/State/Zip:
Tel. Ext. Fax: Tel. Ext. Fax:
Email:
Email:
Lead Attorney Select Select
Lead Attorney
Name: Name:
Bar No. Bar No. -it EY7C(
Firm Name: Firm Name:
Address I: Address I:
Address 2: Address 2:
City/State/Zip: City/State/Zip:
Tel. Ext. Fax:
Tel. Ext. Fax:
Email: Email:
Page I of 10
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V. Perfection of Appeal, Judgment and Sentencing ,, A fl A i
—.
Nature of Case (Subject matter or type of case):
Date Order or Judgment signed://j’gq_ /.% / Pype ofJu gment:
Date Notice oAppeal filed in Trial Court: /9lct ;)o/s::)
If mailed to the Trial Court clerk, also give the date mailedzI3cptuL)t’
Interlocutory appeal of appealable order: Yes No %7A.t’
If yes, please specify statutory or other basis on which interlocutory order is appealable (See TRAP 28):
Accelerated Appeal (See TRAP 28): Yes
If yes, please specify statutory or other basis on which a peal is accel rated:
0 zt W Y #L/L. %t .aoj
,
Parental Termination or Child Protection? (See TRAP 28.4): Yes No
Permissive?(SeeTRAP28.3): Yes No
If yes, please specify statutory or other basis for such kws:
Aizreed? (See TRAP 28.2): Yes
If yes, please specify statutory or other basis for such status:
Appeal should receive precedence, preference, or priority under statute or rule? Yes
If yes, p1 ase sp ify tatutory or other basis for such sta s:
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Does this case involve an amount under SI 00,000? Yes T0
Judgment or Order disposes of all parties and issues? Yes
Appeal from finaL judgment? No
Does the appeal involve the constitutionality or the validity of a statute, rule, or ordinance? Ye No
VI. Actions Extending Time To Perfect Appeal
Motion for New Trial: Yes If yes, date filed:
Motion to Modify Judgment: Yes If yes, date filed:
Request for Findings of Fact and Conclusions of Law:
Yes No If yes, date filed:
Motion to Reinstate: Yes No If yes, date filed: •.4vça,.cL? 9—
Motion under TRCP 306a: Yes No If yes, date filed: ,, 7 4
Other: Yes No
21%
7
If Other, please specify: €2_IC.,
iZ 4, 4
,(QCec4Ld
Page 3 of 10
VII. Indigency of Party (Attach file stamped copy of Statement and copy of the trial court order.)
Was Statement of Inability to Pay Court Costs filed in the trial court? No
If yes, date filed: Qb—at
Was a Motion Challenging the Statement filed in the trial court? Yes
If yes, date filed:
Was there any hearing on appellant’s ability to afford court costs? Yes
Hearing Date:
Did trial court sign an order under Texas Rule of Civil Procedure 145? •Yes No
Date ofOrder:fl/t9/27eLZ€cc — Ao’/zeZtL
If yes, trial court finSing: Challenge Sustained Overrulcd
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VIII. Bankruptcy 6
Has any party to the court’s judgment filed for protection in bankruptcy which might affect this appeal?
Yes
If yes, please attach a copy of the petition.
Date bankruptcy filed: li/n
Bankruptcy Case Number:
IX. Trial Court and Record
Court .(Jijajt2t 45trt,Sje, 4 Clerk’s Record
CountY:t//,h Trial Court Cl eric: District County
Trial Court Docket No. (Cause No.): Was Clerk’s record rcqucstcd? No
If yes, date requested: fli4ny /S. €3D/?’
Trial Court Judge (who tried or disposed of the case):
If no, date it will be requested:
Namc: J71%e J%[-ZLc/e4J Were payment arrangements made with clerk7
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Address I
Yes No en
Address 2%o3 /
city/state/zip:47cL21Vrfttji’75’0 7/ (Note: No request required under TRAP 345(a),(b%)
Tel. Ext. Fax:
Email:
Page 4 of 10
IX. Trial Court and Record Continued -
Reporter’s or Recorder’s Record
Is there a Reporter’s Record? No ,S.fi4t4_7. 0 / P1 Y p2Lcat_)
Was Reporter’s Record requested? No
If yes, date requested: /77 a.g.’ /9 c20 12’
If no, date it will be requested:
Was the Reporter’s Record electronically recorded? Yes
Were payment arrangements made with the court reporter/court recorder? Yes No
Court Reporter Court Recorder Court Reporter Court Recorder
Official Substitute Official Substitute
Name: /
GLt
Name:
CWoHC2
Address 1: Address 1:
Address 2: AaI ‘* Address 2:
City/State/Zip: City/State/Zip:
Tel. Ext. Fax: Tel. Ext. Fax:
Email: Email:
X. Supersedeas Bond
Supersedeas bond filed? Yes
If yes, date filed:
Ifno, will file? Yes
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XI. Extraordinary Relief
Will you request extraordinary relief (e.g., temporary or ancillary relief) from this Court? Yes No
If yes, bricif state the ba is for your request:
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Page 5 of 10
Xli. Alternative Dispute Resolution/Mediation
4th, 8th, 13th,
(Complete section if filing in the 1st, 2nd, 5th, or 14°’ Court of Appeals.)
Should this appeal be refeiTed to mediatlo es No
S*ei— _&rQe? I
[las this case been through an ADR procedure? Yes
If yes, who was the mediator?
What type of ADR procedure?
At what stage did the case go through ADR? Pre-Trial Post-Trial Other
If other, please speciI’:
Type of Case? Select
Give a brief description of the issue to be raised on appeal, the relief sought, and the applicable standard for review, if
knoyn (witho t prejudice to the ght to raise additional issues or request additional relief):
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4 ca4tea4 Sgu c/?ü72A,
LtkL9t41 d 7t*ft%hcv ,tzt 9ae eczyt.*
How the case disposed of& TC2fl /Z7t.t2/t/LdLtt.t..,fLec& a-v-cA
Summary of relief granted, mci toltttmoney judgment, and if any, damages awarded. >t2,v
O& A-., .L!a ,f 1c..
If money judgment, what was the amount? Actual damages:fl.1 ac9Oo ,p
Punitive (or similar) damages: / ?
Attorney’s fees
Attorney’s fees (appellate):
cspad4/ aaç
Will you challenge this Court sjunsdiction? Yes No
Does judgment have language that one or more parties “take nothing”? es No
Does judgment have a Mother Hubbard clause? Yes No
. Y7’
Othcr basis for finality:
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Pageóof 10 .Z1t/ /9
XII. Alternative Dispute ResolutionfMediatiopConfinued
(çompietesectioniffillng_in the 1st, 2nd(5th26th, 8th, 10th, 13th, or 14°’ Court of Appeals.)
N”
Rate the complexity of the case (use I for least and 5 for most complex): 1 2 3 4 5
Please make my answer to the preceding questions known to other parties in this case? Yes
Can the parties agree on an appellate mediator? Yes No ‘-a ciujZZ-’7’2nLC
if yes, please give the name, address, telephone, fax, and email address:
Name:
Address:
Telephone: Ext.
Fax:
Email:
Languages other than English in which the mediator should be proficient:
Name of the person filling out mediation section of docketi g state ent:
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XIII. Related Matters
List any pending or past related appeals before/JiJ,oy o)exas Appellate Court, by Court, Docket, and S le.
Court: Select Appellate Courtj?L
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Docket:
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Court: Select Appellate Ci L(Md,JJi: x-aAe-z u,dt--——
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Court: Select Appellate Court Docket:
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Court: Select Appellate aurt cket:’ .
Style:
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Court: Select Appellate Court Docket:
Style:
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Page 7 of 10
XIV. Pro Bono Program:
(Complete section if filing in the I, 2nd, 3rdLj7th, 13th or 14th Court of Appeals.)
The Courts of Appeals listed above, in conjunction with the State Bar of Texas Appellate Section Pro Bono Committee
and local Bar Associations, arc conducting a program to place a limited number of civil appeals with appellate counsel
who will represent the appellant in the appeal before this Court.
The Pro Bono Committee is solely responsible for screening and selecting the civil cases for inclusion in the Program
based upon a number of discretionary criteria, including the financial means of the appellant or appellee. If a case is
selected by the Committee, and can be matched with appellate counsel, that counsel will take over representation of the
appellant or appellee without charging legal fees. More information regarding this program can be found in the Pro Bono
Program Pamphlet available in paper form at the Clerks Office or on the Internet at jflp: \ww.tex-jJg. If your case
is selected and matched with a volunteer lawyer, you will receive a letter from the Pro Bono Committee within thirty (30)
to forty-five (45) days after submitting this Docketing Statement.
Note: there is no guarantee that if you submit your case for possible inclusion in the Pro Bono Program, the Pro Bono
Committee will select your ease and that pro bono counsel can be found to represent you. Accordingly, you should not
forego seeking other counsel to represent you in this proceeding. By signing your name below, you are authorizing the
Pro Bono committee to transmit publicly available facts and information about your case, including parties and
background, through selected Internet sites and Listserv to its poo1 of volunteer appellate attorneys.
Do you want this case to be considered for inclusion in the Pro Bono Program? ,‘Yes UNo
Do you authorize the Pro Bono Committee to contact your gal counsel of record in this matter to answer questions the
committee may have regarding the appeal? Q Yes MNo Sn.. a*.tr
Please note that any such conversations would be maintained as confiden’Iial by the Pro Bono Committee and the
information used solely for the purposes of considering the case for inclusion in the Pro Bono Program.
If you have not previously filed a Statement of Inability to Pay Court Costs and attached a file-stamped copy of that
Statement, doe your income exceed 200% of the U.S. Department of Health and Human Services Federal Poverty
Guidelines? Yes QNo
These guidelines can be found in the Pro Bono Program Pamphlet as well as on the internet at
hiPzjl1.hhs.uo
Are you willing to disclose your financial circumstances to the Pro Bono Committee? ‘Yes ONo
If yes, please attach a Statement of Inability to Pay Court Costs completed and executed by the appellant or appellec.
Sample forms may be found in the Clerk’s Office or on the internet at Your participation in
the Pro Bono Program may be conditioned upo your eecution of a Statement under oath as to your financial
circumstances.
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Give a brief description of the issues to be raised on appeal, the relief sought, and the applicable standard of review, if
known (without prejudice to the ht to raise dditiona issues or request additional relief; use a separate attachment, if
necessary)./ LJ1&t5¼tercea (/5
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PageS of 10
XV. Signature
&a’
g ure o counsel (or Pro Se Party) Date
w&Lena
ri te ame
. Fn./,setr %,Lq ;n State Bar No.
Is! Your Name
Electronic Signature (Optional) Name
XVI. Certificate of Service
The undersigied counsel certifies that this Docketing Statement has been served on the following lead counsel for all
parties to the Trial Court’s Order or Judgment as folio s on:
4 nsc (oh?65e Party)
J2our Name
Electronic Signature (Optional)
/ekan
Certificate of Service Requirements (TRAP 9.5(e)): A certificate of service must be signed by the person who made the service and
must state:
(I) the date and manner of service;
(2) the name and address of each person served, and
(3) if the person served isa party’s attorny, the name of the party represented by the attorney.
Page 9 of 10
I Please enter the following for each person served:
. g4 07Z—
Date Served: c? 8 6?& / 8- Date Served: n_ 7
Manner Served: Select %/, S 7-.t% Manner Served: Select
ts—e( %L_.
Name: Name: c’oj
Bar No. Bar No. abd&t4t
icm.Name:
1
.
. d Firm Name:
Address I: /7oy
Address 1:
Address 2: Address 2: n
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cityistateizip:c_ Y(n1ty.j iK ‘O 7/ City/State/Zip: 7E 75a /
Fa() 61&’- r;c?Y
Tch7fg E1. Fax: TejQJ%
coo
EmailQ
E?—
Part%y%
Date Served: 3t 3C ,&/?‘ Date Served: .5— S’ — S-tO /J
Manner Served: Select Manner Served: Select Zt, 5_
Nam 5, e4SLa
Bar N2%JN
Firm N amet% Firm NamejL
,‘a-iZ, JOtI%J4
Address I :/ pz Address 1:
7%
Address 2
S%%4J %‘c Address 2: —3ç.-
City/State/Zip: Jf%
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C1tY/State/ZiP.,.A..&
7stcy
Email: Em4’Z’ /2QD 573—
Party: 2 c Part
Date Served: 9<... S3C &o/
Manner Served: Select/,
Name)fl1
5
Bar No.
Firm Name
kA#t r%21%
Address 1:
Address 2: 7c’/
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CitY/State/ZiP:Ytic<,/
Tel.pj. Ext. Fax:
2 700 6t_.
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10 of 10
Court of Appeals May 28, 2018
Fifth District Court
George Allen Building
RECEIVED
COURT OF APPEALS
600 Commerce Street, Suite # 200 JUN o 12018
Dallas, TX. 75202-4658 LISA MATZ
CLERK, 5th DISTRICT
Re: Appellant’s Second Docket Statement, Civil Court Docket Form & Affidavit on In
Ability To Pay Court Costs & Detailed Information
Dear Court Clerk.
You will find one original & two copies of Appellant’s Second Docket Statement, Civil
Court Docket Form & Affidavit on In Ability To Pay Court Costs & Detailed Information
with one return of each file stamped copies in prepaid envelope provided.
Thank you for your assistance in filing these documents with the Court of Appeals, Fifth
District Court of Dallas.
Respectfully submitted.
e - .
Darlene C. Balistreri-Amrhein. Realtor / Plaintiff, Pro Se
-_
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