FORM A(Rule 3(1))

(To be used where Notice is filed by Counsel on Behalf of Appellant)

(This Form A may be varied to meet the case where the Attorney General is the appellant, or where circumstances require changes in it.)

20.... No.

In the Supreme Court of Newfoundland and Labrador — Court of appeal


(name of appellant) who was

convicted at

(name of town/city) in the Province

of Newfoundland and Labrador

by Judge


(Name of Appellant)




as represented by the Attorney General


Notice of Appeal (Or Notice of Application for Leave to Appeal) (Or Notice of Cross-Appeal)

  • 1 Section of the Criminal Code pursuant to which the appeal is taken

  • 2 Place of trial

  • 3 Name of judge

  • 4 Name of court

  • 5 Name of crown prosecutor at trial

  • 6 Name of defence counsel at trial

  • 7 Offence(s) of which appellant convicted

  • 8 Sections of the Criminal Code or other statutes under which appellant convicted

  • 9 Plea at trial

  • 10 Length of trial

  • 11 Sentence imposed

  • 12 Date of conviction

  • 13 Date of imposition of sentence

  • 14 If the appellant is in custody, place of incarceration

  • 15 Appellant’s date of birth

  • 16 Appellant’s last known address

  • 17 Trial court case number

Take notice that the appellant (insert whichever of the following is applicable)

  • (a) appeals against conviction on grounds involving a question of law alone;

  • (b) applies for leave to appeal conviction on grounds involving a question of fact alone or a question of mixed law and fact, and if leave is granted, hereby appeals against the said conviction; or

  • (c) applies for leave to appeal against sentence, and if leave be granted hereby appeals against sentence.

The grounds of appeal are annexed hereto as “Appendix A”.

The relief sought is

Note: If the appellant had a right to be tried by judge and jury originally but chose a judge alone, the appellant would have the right to be tried by judge and jury if a new trial is ordered but only if the appellant indicates a desire to be so tried in this notice.

If a new trial is ordered and the appellant would have the right to trial by judge and jury, does the appellant wish trial by
judge and jury?Yes No

The appellant’s address for service is

Dated at , Newfoundland and Labrador, this day of , 20

(Counsel on behalf of appellant)


The Registrar

Court of Appeal

P.O. Box 937

287 Duckworth Street

St. John’s

Newfoundland and Labrador

A1C 5M3

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