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No information is available for this page. Sample Form J. CIVIL CASE INFORMATION STATEMENT - INSTRUCTIONS.The Civil Case Information Statement must be filed in the Court of Appeal within 15. SUPERIOR COURT CASE NUMBER: CIVIL CASE INFORMATION STATEMENT. APP-004. Enter the complete caption or title of the case exactly as it appears on the papers from the trial court or agency (for example, the complaint or indictment). You must complete the form,. Affidavit To Withhold Identifying. NOTE TO APPELLANT: You must file this form with the clerk of the Court of Appeal within 15 days after the clerk mails you. Civil Case Information Statement. Please type or clearly print all information.