Notice is hereby given that ............................................................................................................ hereby appeals to the United States Court of Appeals for the Circuit from [that part of] the decision of this court entered in the above-captioned proceeding on the ........... day of ............ [relating to ....................].

..........................................................  Party(*) or Counsel ..........................................................  Post office address ..........................................................  Counsel's Tax Court Bar Number

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* If husband and wife are parties, then both must sign if both want to appeal.