ACCEPTED 01-15-00406-cv FIRST COURT OF APPEALS Appellate Docket Number: 01-15-00406-CV HOUSTON, TEXAS 5/20/2015 11:38:20 AM CHRISTOPHER PRINE Appellate Case Style: New Hampshire Insurance Company CLERK
Vs. Candis M. Mora, et al.
Companion Case No.: W1-47304 FILED IN 1st COURT OF APPEALS HOUSTON, TEXAS 5/20/2015 11:38:20 AM Amended/corrected statement: DOCKETING STATEMENT (Civil) CHRISTOPHER A. PRINE Clerk Appellate Court: 1st Court of Appeals (to be filed in the court of appeals upon perfection of appeal under TRAP 32)
I. Appellant II. Appellant Attorney(s)
• Person E Organization (choose one) Organization Name: New Hampshire Insurance CompanT E Lead Attorney First Name: Loren First Name: Middle Name: R. Middle Name: Last Name: Smith Last Name: Suffix: Suffix: , Law Firm Name: Kelly & Smit.C. J Pro Se: 0 Address 1: 4305 Yoakum d. Address 2: City: Houston State: Texas Zip+4: 77006 Telephone: 713-861-9900 ext. Fax: 713-861-7100 Email: lsmith@kellysmithpc.com SBN: 18643800 III. Appellee IV. Appellee Attorney(s) F Person • Organization (choose one) Fi Lead Attorney First Name: Robert First Name: Candis Middle Name: M. Middle Name: M. Last Name: Waltman Last Name: Mora Suffix: Suffix: Law Firm Name: Waltman & Grisham Pro Se: 0 Address 1: 2807 S. Texas Avenue, Suite 201 Address 2: City: Bryan State: Texas Zip+4: 77802 Telephone: 979-694-0900 ext. Fax: 979-693-0840 Email: rob@waltman.com SBN: 20822500 Page 1 of 8 III. Appellee IV. Appellee Attorney(s) F Person • Organization (choose one) • Lead Attorney First Name: Donna First Name: Candis Middle Name: Middle Name: M. 1 Last Name: Emenhiser Last Name: Mora Suffix: Suffix: Law Firm Name: Waltman & Grisham Pro Se: 0 Address 1: 2807 S. Texas Avenue, Suite 201 Address 2: City: Bryan State: Texas Zip+4: 77802 Telephone: 979-694-0900 ext. Fax: 979-693-0840 Email: donnae@waltman.com SBN:
Page 2 of 8 V. Perfection Of Appeal And Jurisdiction Nature of Case (Subject matter or type of case): Worker's Compensation
Date order or judgment signed: 11 1-1Wir Type ofjudgment: Summary Judgment Date notice of appeal filed in trial court: April 24, 2015 If mailed to the trial court clerk, also give the date mailed: Interlocutory appeal of appealable order: Yes X1 No If yes, please specify statutory or other basis on which interlocutory order is appealable (See TRAP 28):
Accelerated appeal (See TRAP 28): fl Yes 0 No If yes, please specify statutory or other basis on which appeal is accelerated:
Parental Termination or Child Protection? (See TRAP 28.4): IlYes • No
Permissive? (See TRAP 28.3): Yes X1 No If yes, please specify statutory or other basis for such status:
Agreed? (See TRAP 28.2): Yes X1 No If yes, please specify statutory or other basis for such status:
Appeal should receive precedence, preference, or priority under statute or rule: Yes X1 No If yes, please specify statutory or other basis for such status:
Does this case involve an amount under $100,000? 7 Yes X1No Judgment or order disposes of all parties and issues: X Yes No Appeal from fmal judgment: X Yes No Does the appeal involve the constitutionality or the validity of a statute, rule, or ordinance? Yes X No
VI. Actions Extending Time To Perfect Appeal
Motion for New Trial: 7 Yes X1 No If yes, date filed: Motion to Modify Judgment: 7Yes IX1 No If yes, date filed: Request for Findings of Fact 7 Yes X1 No If yes, date filed: and Conclusions of Law: Motion to Reinstate: nYes X1 No If yes, date filed: 7 Yes 7 No If yes, date filed: Motion under TRCP 306a: Other: 7 Yes V No If other, please specify:
VII. Indigency Of Party: (Attach file-stamped copy of affidavit, and extension motion if filed.) di Affidavit filed in trial court: • Yes 17 No If yes, date filed: L Contest filed in trial court: •Yes • No If yes, date filed:
Date ruling on contest due:
Ruling on contest: Sustained Overruled Date of ruling: El
Page 3 of 8 VIII. Bankruptcy
Has any party to the court's judgment filed for protection in bankruptcy which might affect this appeal? • Yes E No If yes, please attach a copy of the petition.
Date bankruptcy filed: Bankruptcy Case Number:
IX. Trial Court And Record
Court: 165th District Clerk's Record: County: Harris County, Texas Trial Court Docket Number (Cause No.): 2011-47304 Trial Court Clerk: >< District Was clerk's record requested? • • County F Yes No If yes, date requested: April 24, 2015 Trial Judge (who tried or disposed of case): If no, date it will be requested: First Name: Elizabeth Were payment arrangements made with clerk? Middle Name: Yes X No Indigent Last Name: Ray (Note: No request required under TRAP 34.5(a),(b)) Suffix: Address 1: 201 Caroline, 12th Floor Address 2: City: IMMI State: Zip +4: 77002 Telephone: ext. Fax: Email: -
Reporter's or Recorder's Record: Is there a reporter's record? X Yes 7 No Was reporter's record requested? IX Yes No
Was there a reporter's record electronically recorded? 0 Yes No If yes, date requested: April 24, 2015 If no, date it will be requested: Were payment arrangements made with the court reporter/court recorder? xl Yes No Indigent
Page 4 of 8 Court Reporter X Court Recorder Official Substitute
First Name: Peggy Middle Name: Last Name: Hershelman Suffix: Address 1: - 12th Floor Address 2: City: Houston State: as Zip +4: 77002 Telephone: 713-368-6275 ext. Fax: r Email: peggy_hershelman@justex.net
X. Supersedeas Bond Supersedeas bond filed: ll Yes F No If yes, date filed: _all Will file: . Yes F No
XI. Extraordinary Relief
Will you request extraordinary relief (e.g. temporary or ancillary relief) from this Court? DYes Fr No If yes, briefly state the basis for your request:
XII. Alternative Dispute Resolution/Mediation (Complete section if filing in the 1st, 2nd, 4th, 5th, 6th, 8th, 9th, 10th, 11th, 12th, 13th, or 14th Court of Appeal) Should this appeal be referred to mediation? Yes v I No If no, please specify:1MM of settlement Has the case been through an ADR procedure? nYes i4 No If yes, who was the mediator? hEcy Houston What type of ADR procedure? Miii At what stage did the case go through ADR? If other, please specify: E Pre Trial - • Post Trial - • Other
Type of case? Worker's Compensational' Give a brief description of the issue to be raised on appeal, the relief sought, and the applicable standard for review, if known (without prejudice to the right to raise additional issues or request additional relief):
I_ 1
How was the case disposed of? iummary Judgment Summary of relief granted, including amount of money judgment, and if any, damages awarded. Take Nothing Judgment
Punitive (or similar) damages: • If money judgment, what was the amount? Actual damages:
Page 5 of 8 Attorney's fees (trial): Attorney's fees (appellate): Other: . If other, please specify: Ir .
Will you challenge this Court's jurisdiction? E Yes E No Does judgment have language that one or more parties "take nothing"?>1_<1 Yes H No Does judgment have a Mother Hubbard clause? EYes E No Other basis for fmality? OrcWismissallMMM5 Rate the complexity of the case (use 1 for least and 5 for most complex): H 1>L<1 2 H 3 H 4 H 5 Please make my answer to the preceding questions known to other parties in this case.>LKI Yes H No Can the parties agree on an appellate mediator? H Yes z No If yes, please give name, address, telephone, fax and email address: Name Address Telephone Fax Email
Languages other than English in which the mediator should be proficient: Name of person filing out mediation section of docketing statement: 11■1111
XIII.
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ACCEPTED 01-15-00406-cv FIRST COURT OF APPEALS Appellate Docket Number: 01-15-00406-CV HOUSTON, TEXAS 5/20/2015 11:38:20 AM CHRISTOPHER PRINE Appellate Case Style: New Hampshire Insurance Company CLERK
Vs. Candis M. Mora, et al.
Companion Case No.: W1-47304 FILED IN 1st COURT OF APPEALS HOUSTON, TEXAS 5/20/2015 11:38:20 AM Amended/corrected statement: DOCKETING STATEMENT (Civil) CHRISTOPHER A. PRINE Clerk Appellate Court: 1st Court of Appeals (to be filed in the court of appeals upon perfection of appeal under TRAP 32)
I. Appellant II. Appellant Attorney(s)
• Person E Organization (choose one) Organization Name: New Hampshire Insurance CompanT E Lead Attorney First Name: Loren First Name: Middle Name: R. Middle Name: Last Name: Smith Last Name: Suffix: Suffix: , Law Firm Name: Kelly & Smit.C. J Pro Se: 0 Address 1: 4305 Yoakum d. Address 2: City: Houston State: Texas Zip+4: 77006 Telephone: 713-861-9900 ext. Fax: 713-861-7100 Email: lsmith@kellysmithpc.com SBN: 18643800 III. Appellee IV. Appellee Attorney(s) F Person • Organization (choose one) Fi Lead Attorney First Name: Robert First Name: Candis Middle Name: M. Middle Name: M. Last Name: Waltman Last Name: Mora Suffix: Suffix: Law Firm Name: Waltman & Grisham Pro Se: 0 Address 1: 2807 S. Texas Avenue, Suite 201 Address 2: City: Bryan State: Texas Zip+4: 77802 Telephone: 979-694-0900 ext. Fax: 979-693-0840 Email: rob@waltman.com SBN: 20822500 Page 1 of 8 III. Appellee IV. Appellee Attorney(s) F Person • Organization (choose one) • Lead Attorney First Name: Donna First Name: Candis Middle Name: Middle Name: M. 1 Last Name: Emenhiser Last Name: Mora Suffix: Suffix: Law Firm Name: Waltman & Grisham Pro Se: 0 Address 1: 2807 S. Texas Avenue, Suite 201 Address 2: City: Bryan State: Texas Zip+4: 77802 Telephone: 979-694-0900 ext. Fax: 979-693-0840 Email: donnae@waltman.com SBN:
Page 2 of 8 V. Perfection Of Appeal And Jurisdiction Nature of Case (Subject matter or type of case): Worker's Compensation
Date order or judgment signed: 11 1-1Wir Type ofjudgment: Summary Judgment Date notice of appeal filed in trial court: April 24, 2015 If mailed to the trial court clerk, also give the date mailed: Interlocutory appeal of appealable order: Yes X1 No If yes, please specify statutory or other basis on which interlocutory order is appealable (See TRAP 28):
Accelerated appeal (See TRAP 28): fl Yes 0 No If yes, please specify statutory or other basis on which appeal is accelerated:
Parental Termination or Child Protection? (See TRAP 28.4): IlYes • No
Permissive? (See TRAP 28.3): Yes X1 No If yes, please specify statutory or other basis for such status:
Agreed? (See TRAP 28.2): Yes X1 No If yes, please specify statutory or other basis for such status:
Appeal should receive precedence, preference, or priority under statute or rule: Yes X1 No If yes, please specify statutory or other basis for such status:
Does this case involve an amount under $100,000? 7 Yes X1No Judgment or order disposes of all parties and issues: X Yes No Appeal from fmal judgment: X Yes No Does the appeal involve the constitutionality or the validity of a statute, rule, or ordinance? Yes X No
VI. Actions Extending Time To Perfect Appeal
Motion for New Trial: 7 Yes X1 No If yes, date filed: Motion to Modify Judgment: 7Yes IX1 No If yes, date filed: Request for Findings of Fact 7 Yes X1 No If yes, date filed: and Conclusions of Law: Motion to Reinstate: nYes X1 No If yes, date filed: 7 Yes 7 No If yes, date filed: Motion under TRCP 306a: Other: 7 Yes V No If other, please specify:
VII. Indigency Of Party: (Attach file-stamped copy of affidavit, and extension motion if filed.) di Affidavit filed in trial court: • Yes 17 No If yes, date filed: L Contest filed in trial court: •Yes • No If yes, date filed:
Date ruling on contest due:
Ruling on contest: Sustained Overruled Date of ruling: El
Page 3 of 8 VIII. Bankruptcy
Has any party to the court's judgment filed for protection in bankruptcy which might affect this appeal? • Yes E No If yes, please attach a copy of the petition.
Date bankruptcy filed: Bankruptcy Case Number:
IX. Trial Court And Record
Court: 165th District Clerk's Record: County: Harris County, Texas Trial Court Docket Number (Cause No.): 2011-47304 Trial Court Clerk: >< District Was clerk's record requested? • • County F Yes No If yes, date requested: April 24, 2015 Trial Judge (who tried or disposed of case): If no, date it will be requested: First Name: Elizabeth Were payment arrangements made with clerk? Middle Name: Yes X No Indigent Last Name: Ray (Note: No request required under TRAP 34.5(a),(b)) Suffix: Address 1: 201 Caroline, 12th Floor Address 2: City: IMMI State: Zip +4: 77002 Telephone: ext. Fax: Email: -
Reporter's or Recorder's Record: Is there a reporter's record? X Yes 7 No Was reporter's record requested? IX Yes No
Was there a reporter's record electronically recorded? 0 Yes No If yes, date requested: April 24, 2015 If no, date it will be requested: Were payment arrangements made with the court reporter/court recorder? xl Yes No Indigent
Page 4 of 8 Court Reporter X Court Recorder Official Substitute
First Name: Peggy Middle Name: Last Name: Hershelman Suffix: Address 1: - 12th Floor Address 2: City: Houston State: as Zip +4: 77002 Telephone: 713-368-6275 ext. Fax: r Email: peggy_hershelman@justex.net
X. Supersedeas Bond Supersedeas bond filed: ll Yes F No If yes, date filed: _all Will file: . Yes F No
XI. Extraordinary Relief
Will you request extraordinary relief (e.g. temporary or ancillary relief) from this Court? DYes Fr No If yes, briefly state the basis for your request:
XII. Alternative Dispute Resolution/Mediation (Complete section if filing in the 1st, 2nd, 4th, 5th, 6th, 8th, 9th, 10th, 11th, 12th, 13th, or 14th Court of Appeal) Should this appeal be referred to mediation? Yes v I No If no, please specify:1MM of settlement Has the case been through an ADR procedure? nYes i4 No If yes, who was the mediator? hEcy Houston What type of ADR procedure? Miii At what stage did the case go through ADR? If other, please specify: E Pre Trial - • Post Trial - • Other
Type of case? Worker's Compensational' Give a brief description of the issue to be raised on appeal, the relief sought, and the applicable standard for review, if known (without prejudice to the right to raise additional issues or request additional relief):
I_ 1
How was the case disposed of? iummary Judgment Summary of relief granted, including amount of money judgment, and if any, damages awarded. Take Nothing Judgment
Punitive (or similar) damages: • If money judgment, what was the amount? Actual damages:
Page 5 of 8 Attorney's fees (trial): Attorney's fees (appellate): Other: . If other, please specify: Ir .
Will you challenge this Court's jurisdiction? E Yes E No Does judgment have language that one or more parties "take nothing"?>1_<1 Yes H No Does judgment have a Mother Hubbard clause? EYes E No Other basis for fmality? OrcWismissallMMM5 Rate the complexity of the case (use 1 for least and 5 for most complex): H 1>L<1 2 H 3 H 4 H 5 Please make my answer to the preceding questions known to other parties in this case.>LKI Yes H No Can the parties agree on an appellate mediator? H Yes z No If yes, please give name, address, telephone, fax and email address: Name Address Telephone Fax Email
Languages other than English in which the mediator should be proficient: Name of person filing out mediation section of docketing statement: 11■1111
XIII. Related Matters List any pending or past related appeals before this or any other Texas appellate court by court, docket number, and style.
Docket Number: Trial Court:
Style:
Vs.
Page 6 of 8 XIV. Pro Bono Program: (Complete section if filing in the 1st, 3rd, 5th, or 14th Courts of Ap The Courts of Appeals listed above, in conjunction with the State Bar of Texas Appellate Section Pro Bono Committee and local Bar Associations, are conducting a program to place a limited number of civil appeals with appellate counsel who will represent the appellant in the appeal before this Court.
The Pro Bono Committee is solely responsible for screening and selecting the civil cases for inclusion in the Program based upon a number of discretionary criteria, including the fmancial means of the appellant or appellee. If a case is selected by the Committee, and can be matched with appellate counsel, that counsel will take over representation of the appellant or appellee without charging legal fees. More information regarding this program can be found in the Pro Bono Program Pamphlet available in paper form at the Clerk's Office or on the Internet at www.tex-app.org . If your case is selected and matched with a volunteer lawyer, you will receive a letter from the Pro Bono Committee within thirty (30) to forty-five (45) days after submitting this Docketing Statement. Note: there is no guarantee that if you submit your case for possible inclusion in the Pro Bono Program, the Pro Bono Committee will select your case and that pro bono counsel can be found to represent you. Accordingly, you should not forego seeking other counsel to represent you in this proceeding. By signing your name below, you are authorizing the Pro Bono committee to transmit publicly available facts and information about your case, including parties and background, through selected Internet sites and Listserv to its pool of volunteer appellate attorneys. Do you want this case to be considered for inclusion in the Pro Bono Program? 7 Yes R No Do you authorize the Pro Bono Committee to contact your trial counsel of record in this matter to answer questions the committee may have regarding the appeal? Yes XI No
Please note that any such conversations would be maintained as confidential by the Pro Bono Committee and the information used solely for the purposes of considering the case for inclusion in the Pro Bono Program. If you have not previously filed an affidavit of Indigency and attached a file-stamped copy of that affidavit, does your income exceed 200% of the U.S. Department of Health and Human Services Federal Poverty Guidelines? Yes XI No
These guidelines can be found in the Pro Bono Program Pamphlet as well as on the intemet at http://aspe.hhs.gov/poverty/06poverty.shtml. Are you willing to disclose your financial circumstances to the Pro Bono Committee? Yes XI No If yes, please attach an Affidavit of Indigency completed and executed by the appellant or appellee. Sample forms may be found in the Clerk's Office or on the intemet at http://www.tex-app.or •. Your participation in the Pro Bono Program may be conditioned upon your execution of an affidavit under oath as to your financial circumstances.
Give a brief description of the issues to be raised on appeal, the relief sought, and the applicable standard of review, if known (without prejudice to the right to raise additional issues or request additional relief; use a separate attachment, if necessary).
XV. Signature
Signature of counsel (or pro se party) Date: May 20, 2015
Printed Name: Loren R. Smith State Bar No.: 18643800
Electronic Signature: Loren R. Smith (Optional)
Page 7 of 8 XVI. Certificate of Service
The undersigned counsel certifies that this docketing statement has been served on the following lead counsel for all parties to the trial court's order or judgment as follows on may 20, 2015
Signature of counsel (or pro se party) Electronic Signature: (Optional)
State Bar No.: Person Served Certificate of Service Requirements (TRAP 9.5(e)): A certificate of service must be signed by the person who made the service and must state: (1) the date and manner of service; (2) the name and address of each person served, and (3) if the person served is a party's attorney, the name of the party represented by that attorney
Please enter the following for each person served:
Date Served: May 20, 2015 Manner Served: Email
First Name: Robert
Middle Name: B. Last Name: Suffix: Law Firm Name: Address 1: M. Texas Avenue, Suite 201 Address 2: MN City: Bryan State MIL -.— Zip+4: 77802 Telephone: =94-0900 ext. Fax: Email: i@waltman.com If Attorney, Representing Party's Name: Candis M. Mora
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