*1 Appellate Docket Number: 01-15-00406-CV
*2 | III. Appellee | | IV. Appellee Attorney(s) | | | :--: | :--: | :--: | :--: | | Person | Organization (choose one) | Lead Attorney | | | | | First Name: | Donna | | First Name: | Candis | Middle Name: | | | Middle Name: | M. | Last Name: | Emenhiser | | Last Name: | Mora | Suffix: | | | Suffix: | | | | | Pro Se: | | Law Firm Name: | | | | | Address 1: | 2807 S. Texas Avenue, Suite 201 | | | | Address 2: | | | | | City: | Bryan | | | | State: | Texas | Zip+4: 77802 | | | | Telephone: | 979-694-0900 | ext. | | | | Fax: | 979-693-0840 | | | | | Email: | donnae@waltman.com | | | | | SBN: | 00797835 | |
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V. Perfection Of Appeal And Jurisdiction
| Nature of Case (Subject matter or type of case): Worker's Compensation | | | | :--: | :--: | :--: | | Date order or judgment signed: April 15, 2015 | Type of judgment: | Summary Judgment | | Date notice of appeal filed in trial court: April 24, 2015 | | | | If mailed to the trial court clerk, also give the date mailed: | | | | Interlocutory appeal of appealable order: Yes No | | | | If yes, please specify statutory or other basis on which interlocutory order is appealable (See TRAP 28): | | | | Accelerated appeal (See TRAP 28): Yes No | | | | If yes, please specify statutory or other basis on which appeal is accelerated: | | | | Parental Termination or Child Protection? (See TRAP 28.4): Yes No | | | | Permissive? (See TRAP 28.3): Yes No | | | | If yes, please specify statutory or other basis for such status: | | | | Agreed? (See TRAP 28.2): Yes No | | | | If yes, please specify statutory or other basis for such status: | | | | Appeal should receive precedence, preference, or priority under statute or rule: Yes No | | | | If yes, please specify statutory or other basis for such status: | | | | Does this case involve an amount under ? Yes No | | | | Judgment or order disposes of all parties and issues: Yes No | | | | Appeal from final judgment: Yes No | | | | Does the appeal involve the constitutionality or the validity of a statute, rule, or ordinance? Yes No | | | | VI. Actions Extending Time To Perfect Appeal | | | | Motion for New Trial: Yes No | | If yes, date filed: | | Motion to Modify Judgment: Yes No | | 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: | | Motion under TRCP 306a: | Yes No | If yes, date filed: | | Other: | Yes No | | | If other, please specify: | | | | VII. Indigency Of Party: (Attach file-stamped copy of affidavit, and extension motion if filed.) | | | | Affidavit filed in trial court: Yes No | | If yes, date filed: | | Contest filed in trial court: Yes No | | If yes, date filed: | | Date ruling on contest due: | | | | Ruling on contest: Sustained Overruled | | Date of ruling: |
*4 Has any party to the court's judgment filed for protection in bankruptcy which might affect this appeal?Yes NoIf yes, please attach a copy of the petition.
Reporter's or Recorder's Record: Is there a reporter's record? Was reporter's record requested? Yes No Was there a reporter's record electronically recorded? Yes No If yes, date requested: April 24, 2015 If no, date it will be requested: Were payment arrangements made with the court reporter/court recorder?YesNo Indigent
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| Court Reporter | Court Recorder | | :-- | :-- | | Official | Substitute |
| First Name: | Peggy | | :-- | :-- | | Middle Name: | | | Last Name: | Hershelman | | Suffix: | | | Address 1: | 201 Caroline, 12th Floor | | Address 2: | | | City: | Houston | | State: | Texas Zip + 4: 77002 | | Telephone: | 713-368-6275 ext. | | Fax: | | | Email: peggy hershelman@justex.net | |
X. Supersedeas Bond
Supersedeas bond filed: Yes No If yes, date filed: Will file: Yes No
XI. Extraordinary Relief
Will you request extraordinary relief (e.g. temporary or ancillary relief) from this Court? Yes No If yes, briefly state the basis for your request:
XII. Alternative Dispute Resolution/Mediation (Complete section if filing in the 1st, 2nd, 4th, 5th, 6th, 8th, 9th, 10th, 11th, 12th, 13th, or 14th Court of Appeal)
Should this appeal be referred to mediation? Yes No If no, please specify: No chance of settlement Has the case been through an ADR procedure? Yes No If yes, who was the mediator? Nancy Houston What type of ADR procedure? Mediation At what stage did the case go through ADR? Pre-Trial Post-Trial Other If other, please specify: Type of case? Worker's Compensation Give a brief description of the issue to be raised on appeal, the relief sought, and the applicable standard for review, if known (without prejudice to the right to raise additional issues or request additional relief):
How was the case disposed of? Summary Judgment Summary of relief granted, including amount of money judgment, and if any, damages awarded. Take Nothing Judgment If money judgment, what was the amount? Actual damages: Punitive (or similar) damages:
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Attorney's fees (trial): Attorney's fees (appellate): Other: If other, please specify:
Will you challenge this Court's jurisdiction? Yes No Does judgment have language that one or more parties "take nothing"? Yes No Does judgment have a Mother Hubbard clause? Yes No Other basis for finality? Order of Dismissal of April 15, 2015 Rate the complexity of the case (use 1 for least and 5 for most complex): Please make my answer to the preceding questions known to other parties in this case. Yes No Can the parties agree on an appellate mediator? Yes No If yes, please give name, address, telephone, fax and email address: Name Address Telephone Fax Email
Languages other than English in which the mediator should be proficient: Name of person filing out mediation section of docketing statement:
XIII. Related Matters
List any pending or past related appeals before this or any other Texas appellate court by court, docket number, and style. Docket Number: Trial Court: Style: V.
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XIV. Pro Bono Program: (Complete section if filing in the 1st, 3rd, 5th, or 14th Courts 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, are 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 Clerk's Office or on the Internet at www.tex-app.org. 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 case 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 pool of volunteer appellate attorneys. Do you want this case to be considered for inclusion in the Pro Bono Program? Yes No Do you authorize the Pro Bono Committee to contact your trial counsel of record in this matter to answer questions the committee may have regarding the appeal? Yes No Please note that any such conversations would be maintained as confidential 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 an affidavit of Indigency and attached a file-stamped copy of that affidavit, does your income exceed 200\% of the U.S. Department of Health and Human Services Federal Poverty Guidelines? Yes No These guidelines can be found in the Pro Bono Program Pamphlet as well as on the internet at http://aspe.hhs.gov/poverty/06poverty.shtml. Are you willing to disclose your financial circumstances to the Pro Bono Committee? Yes No If yes, please attach an Affidavit of Indigency completed and executed by the appellant or appellee. Sample forms may be found in the Clerk's Office or on the internet at http://www.tex-app.org. Your participation in the Pro Bono Program may be conditioned upon your execution of an affidavit under oath as to your financial circumstances.
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 right to raise additional issues or request additional relief; use a separate attachment, if necessary).
XV. Signature
Signature of counsel (or pro se party) Date: May 20, 2015
Printed Name: Loren R. Smith State Bar No.: 18643800
Electronic Signature: Loren R. Smith (Optional)
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XVI. Certificate of Service
The undersigned 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 follows on May 20, 2015
Signature of counsel (or pro se party) Electronic Signature: (Optional) State Bar No.:
Person Served
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: (1) the date and manner of service; (2) the name and address of each person served, and (3) if the person served is a party's attorney, the name of the party represented by that attorney
Please enter the following for each person served:
| Date Served: | May 20, 2015 | | :-- | :-- | | Manner Served: | Email | | First Name: | Robert | | Middle Name: | B. | | Last Name: | Waltman | | Suffix: | | | Law Firm Name: | WALTMAN &; GRISHAM | | Address 1: | 2807 S. Texas Avenue, Suite 201 | | Address 2: | | | City: | Bryan | | State | Texas Zip+4: | | Telephone: | | | Fax: | | | Email: rob@waltman.com | |
If Attorney, Representing Party's Name: Candis M. Mora