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22

Notice of Appeal Form

UNITED STATES DISTRICT COURT FOR THE

DISTRICT OF

UNITED STATES OF AMERICA,

Plaintiff

v.

[NAME OF DEFENDANT],
Defendant

Case No.

NOTICE OF APPEAL

Notice is hereby given that the United States of America, plaintiff in the above-captioned case, hereby appeals to the United States Court of Appeals for the Circuit from the order of this Court [describe order appealed from], entered on [date order was entered]. [If the order appealed from is an order suppressing or excluding evidence or requiring the return of seized property, include the following language: "I hereby certify that the appeal is not taken for purpose of delay and that the evidence is a substantial proof of a fact material in the proceeding."].

[SIGNATURE BLOCK]