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.)
