Official Form 417A (12/15) Preview on Page 1

Official Form 417A (12/15) 2026

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  1. Click ‘Get Form’ to open Official Form 417A (12/15) in the editor.
  2. In Part 1, enter the name(s) of the appellant(s) in the designated field. Specify their position in the adversary proceeding or bankruptcy case by selecting the appropriate checkbox.
  3. For Part 2, describe the judgment, order, or decree being appealed from and provide the date it was entered.
  4. In Part 3, list all parties involved in the appeal along with their attorneys' names, addresses, and phone numbers. Use additional pages if necessary.
  5. If applicable, check the box in Part 4 to elect for your appeal to be heard by the United States District Court instead of the Bankruptcy Appellate Panel.
  6. Finally, sign and date at Part 5. Include your contact information if you are not represented by an attorney.

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