IN THE JUSTICE COURT OF COUNTY, STATE OF MONTANA

BEFORE , JUSTICE OF THE PEACE

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STATE OF MONTANA, * CAUSE NO.

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Plaintiff, * NOTICE OF APPEAL

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vs. *

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, *

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Defendant. *

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Notice is hereby given that , the Plaintiff/Defendant above named, hereby appeals the District Court of the Judicial District, County, State of Montana, from the judgment entered in this action on the day of , 19 .

The Justice of the Peace is requested to set a bond on appeal.

DATED this day of , 19 .

Plaintiff/Defendant

CERTIFICATE OF SERVICE

I hereby certify that a true and correct copy of the Notice of Appeal was served upon the Plaintiff/Defendant or their attorney(s) by placing the same in the U.S. mails, postage fully paid thereon, addressed as follows:

Plaintiff/Defendant