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Office of the Revisor of Statutes

APPELLATE PROCEDURE

Forms provided here are for reference purposes. To download forms to fill out please visit the Minnesota Courts website.

FORM 115B - WRIT OF CERTIORARI

STATE OF MINNESOTA

IN COURT OF APPEALS

CASE TITLE:
WRIT OF CERTIORARI
Relator,
vs.COURT OF APPEALS NUMBER:
Respondent,(AGENCY OR BODY)
NUMBER:
(Agency or Body), Respondent.DATE OF DECISION:
TO:(Agency or Body)

You are hereby ordered to return to the Court of Appeals and serve on all parties in accordance with Rule 115.04, subdivision 3, within 30 days after service of the petition or 14 days after delivery of a transcript, whichever is later, an itemized statement of the record, exhibits and proceedings in the above-entitled matter so that this court may review the decision of the (agency or body) issued on the date noted above.

You are further directed to retain the actual record, exhibits, and transcript of proceedings (if any) until requested by the clerk of the appellate courts to deliver them in accordance with Rule 115.04, subdivision 5.

Copies of this writ and accompanying petition shall be served forthwith either personally or by mail upon the respondent (agency or body) and upon the respondent or its attorney at:

_
_
(address)

Proof of service of the writ and of the itemized list shall be filed with the clerk of the appellate courts.

DATED:
Clerk of Appellate Courts
(Clerk's File Stamp)
By: _
Assistant Clerk

(Amended effective for appeals taken on or after January 1, 1992; amended effective January 1, 1999; amended effective January 1, 2010.)