Rule 5531. Description of action. The appellant shall file together
with the record on appeal, in both criminal and civil actions, a
statement containing the following information listed and numbered in
the following order:

1. the index number of the case in the court below,

2. the full names of the original parties and any change in the
parties,

3. the court and county in which the action was commenced,

4. the date the action was commenced and the dates on which each
pleading was served,

5. a brief description of the nature and object of the action,

6. a statement as to whether the appeal is from a judgment or an order
or both, the dates of entry of each judgment or order appealed from, and
the name of the judge or justice who directed the entry of the judgment
or made the order being appealed, and

7. a statement as to the method of appeal being used:

(a) whether the appeal is on a full record, printed or reproduced, or

(b) on the original record, in which event, state whether the appendix
method is being used, or leave to prosecute the appeal on the original
record was granted by the court or by statute.

The statement shall be prefixed to the papers constituting the record
on appeal. A copy of this statement shall be filed with the clerk at the
time the record on appeal is filed.