MINNESOTA COURT RULES

APPELLATE PROCEDURE

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

FORM 139 - TAXATION OF COSTS AND DISBURSEMENTS

STATE OF MINNESOTA	□ Supreme Court
	□ Court of Appeals

Case Title	Appellate Court
	Case Number:	NOTICE, STATEMENT AND CLAIM OF
		COSTS AND DISBURSEMENTS INCURRED
		BY PREVAILING PARTY

	Prevailing Party:
	_
	□ Appellant	□ Respondent	□ Relator

COSTS AND DISBURSEMENTS
Statutory Costs.	$_ 300.00	Printing Appellant's brief and Appendix.	$_
Clerk of The Appellate Courts Filing Fee.	$_	Postage.	$_
Transcript of case used for appeal to Appellate Courts only.	$_	Premium on appeal bond.	$_
Printing of Respondent's brief...	$_	Other.	$_
The above bill of Costs and Disbursements taxed and allowed_
		Dated
_		By _
Clerk of the Appellate Courts		Assistant Clerk
STATE OF MINNESOTA
County of _

Being duly sworn, I the attorney for the prevailing party in the above-entitled action, state that the above is a true and correct statement of costs incurred and disbursements made by the prevailing party in that action.

NOTARY STAMP, SIGNATURE AND DATE:	Respectfully,
_	_
Dated	Attorney's Name
_	_
Signature	Address
	_
	Signature
_
NOTICE TO ATTORNEY FOR ADVERSE PARTY(S):	Costs and disbursements will be taxed pursuant to Rule 139.03 (Rules of Civil
ADVERSE PARTY(S) BEING TAXED:	Appellate Procedure), objections thereto may be filed pursuant to Rule 139.04.
_	_
ATTORNEY	ATTORNEY
For_	For_
(Name of Party)	(Name of Party)
_	_
ATTORNEY	ATTORNEY
For_	For_
(Name of Party)	(Name of Party)

(Added effective January 1, 1999.)