To the Supreme Court of Alabama
Petitioner
v.
Respondent
In the Circuit Court of ____________ County
Civil Action No. _____________________
____________________
Date of Interlocutory Order
Comes now ______ and petitions the Court for permission to take an appeal from an interlocutory order not otherwise appealable, and, in support thereof, shows the following:
(1) [Give statement of facts necessary to an understanding of the controlling question of law determined in the trial court order.]
(2) [Give a statement of the controlling question of law.]
(3) [Give a statement of (a) the reasons why a substantial basis exists for a difference of opinion on the question; (b) why an immediate appeal would materially advance the termination of the litigation; and (c) why the appeal would avoid protracted and expensive litigation.]
(4) A copy of the order appealed from including any findings of fact, conclusions of law and opinion relating thereto is attached hereto.
(5) Attached hereto is the certificate of the trial judge, as required by Rule 5(a).
I certify that I have this date served a copy hereof on counsel for respondent.
DATED this _____ day of _____, 19__.
____________________
Counsel for Petitioner
____________________
____________________
Ala. R. App. P. Form 16