Haw. R. Civ. P. Form 29-C

IN THE CIRCUIT COURT OF THE (insert the judicial circuit no.) CIRCUIT

STATE OF HAWAIʻI

(Your Name), ) Civil No.

)

Appellant, ) Agency Docket/Case No.

)

v. )

) ORDER FOR CERTIFICATION AND

(Name of governmental official or agency, ) TRANSMISSION OF RECORD

whose order or decision is being appealed); )

(Name(s) of any other party to the proceeding )

before the official or agency), )

)

Appellee(s). )

)

ORDER FOR CERTIFICATION AND TRANSMISSION OF RECORD

TO: (Insert name of agency that made the decision being appealed)

(Address of agency)

In accordance with section 91-14(d), Hawaiʻi Revised Statutes, and Rule 72(d) of the Hawaiʻi Rules of Civil Procedure, you are hereby ordered to certify and transmit to this Court, within twenty (20) calendar days of the date of this Order, or within such further time as may be allowed by this Court, the entire record as defined by section 91-9(e), Hawaiʻi Revised Statutes, and as set forth in the Designation of Record on Appeal. Any request to enlarge time shall be submitted to the Court prior to the expiration of the above 20-day period.

DATED: (Name of the City the Court is in), (Name of State), ______________.

CLERK OF THE ABOVE-ENTITLED COURT