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CGi'iI~~IALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
NOTICE OF APPEAL
FROM
JUDICIAL DISTRICT
DISTRICT JUSTICE JUDGMENT
COMMONPLEASN... ~-li.frt c.~Jrllf1Yl
NOTICE OF APPEAL 3/14/00
No~ce is given that the apPellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the District Justice on the
dale and in .the case mentioned bel"",
ZIP CODE
00/3
a-n,;:1-
QAIM NO
CV 1~
LT 19
This block will be signed'ONLY when this nota~on is required under Po. R.cPJ.P. No.
10088.
This Notice of Appea!., when received by the District Justice, will operate as 0
SUPERSI:DEAS ta the judgment far possession in this case.
8.-00
. .
Signalure of Profhon_y or Deputy
appellant was CLAI !ANT (see Pa. R.C.P.J.P. No.
1001 (6) in action before District Justice, he MUST
FILE A COMPLAINT within twenty (20) days after
filing his NOTICE of APPEAL.
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This seethm of form to be used ONLY when appellant was DEFENDANT (see Pa. R.C.P.J.P. No. 1001(7) In action before DIsfflct Justice.
IF NOT USED, detach from copy of notice of appeal to be served upon appellee).
PRAECIPE: To Prothonotary
Enler rule upon
Name of appeflee(s)
, appellee(s), ta file a complaint in this appeal
(Common Pleas No.
) within twenty (20) days after service of rule or suffer entry of judgment of non pros.
Signature of appeIfant or his attorney or agent
RULE: Te>
Name of awe//oe(s)
. appellee(s).
(11 You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty (20) days afler the dale of
service of this rule upon you by personal service or by certified or registered maiL
(2111 you do not file a complaint within this time, a JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOu.
(31 The date af service of this rule if service was by mail is the dale of mailing.
Date:_
.19_.
Signature of Fro~ 01 Deputy
AOPC 312.64
COURT FILE TO BE FILED WITH PROTHONOTARY
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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FilE COMPLAINT
(This proof of service MUST BE FILED WITHIN TEN (10) DA YS AFTER filing the notice bl appeal. Check applicable boxes)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
; ss,
AFFIDAVIT: I hereby swear or affirm that I served
D a copy of the NOlice of Appeal, Common Pleas No. , upon the District Juslice designaled therein on
(dale of service) [I by personal service D by (certified) (registered) mail, sender's
receipt attached hereto, and upon the appellee, (name) , on
, 19_ D by personal service D by (certified) (registered) mail, sender's receipt attached hereto.
and further thaf I served the Rule to File a Complaint accompanying the above Notice of Appeal upon the appeltee(s) to whom
lhe Rule was addressed on , 19~ D by personal service D by (certified) (registered)
mail, sender's receipt attached hereto,
SWORN (AFFIRMED) AND SUBSCRIBED BEFORE ME
THIS
DAY OF
,19_
Signature of affiant
Signature of officia! before whom affidavit was made
Title of official
My commission expires on
,19-
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
09-3-03
NOTICE OF JUDGMENTITRANSCRIPT
CIVIL CASE
PLAINTIFF: NAME and ADDRESS
IHERMAN CHIROPRACTIC CENTER OF CARL"")
1 VALLEY ST.
SUITE 106
~ISLE, PA 17013 ~
VS.
Mag. Dis\. No,'
DJ Name: Hon,
SUSANK. DAY
Add'." 229 MILL STREET, BOX 167
MT. HOLLY SPRINGS. PA
T.,.,"",,(717) 486-7672
17065
DEFENDANT: NAME and ADDRESS
IKECK, ARTHUR
45 BOBCAT ROAD
CARLISLE, PA 17013
L
Docket No.: cv- 0000002 - 00
Date Filed: 1/07/00
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,
HERMAN CHIROPRACTIC
1 VALLEY ST.
SUITE 106
CARLISLE, PA 17013
CENTER OF CARL.
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THIS IS TO NOTIFY YOU THAT:
Judgment: FOR DEFENDANT
[iJ Judgment was entered for: (Name) 1l'lU'll' IIR'I'mTR
[iJ Judgment was entered against: (Name) H'RRMIIN CHTROPRIICTHY'J;:NTER OF C
in the amount of $
nn on:
(Date of Judgment)
?/??/nn
o Defendants are jointly and severally liable.
o Damages will be assessed on:
(Date & Time)
O Amount of Judgment Subject to
Attachment/Act 5 of 1996 $
Amount of Judgment $ .00
Judgment Costs $ .00
Interest on Judgment $ .00
Attorney Fees $ .00
Total $ .00
Post Judgment Credits $
Post Judgment Costs $
------------
------------
Certified Judgment Total $
o This case dismissed without prejudice.
o Levy is stayed for
days or 0 generally stayed.
o Objection to levy has been filed and hearing will be held:
Date: Place:
,.
Time:
ANY PARTY HAS THE RIGHT TEAL WITHIN 30 DAYS AFTE THE ENTRY OF JUDGMENT BY FILING A NOTICE
OF APPEAL WITH THE PRO ONOT A Y/CLERK OF THE COU 0 COMMON PLEAS, CIVIL DIVISION. YOU
MUST INCLUDE A COpy 0 THIS NO EOF JUDGME T; C IPT FORM WITH YOUR NOTICE OF APPEAL.
J- r})-"(J{) Dat -
, District Justice
. r e. dings containing the judgment.
, District Justice
My commission expi s first Monday of January,
AOpe 315-99
SEAL
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NOTICE OF APPEAL
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COMMONWIEALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
FROM
JUDICIAL DISTRICT
NOTICE OF APPEAL
I)ISTRICT JUSTICE JUDGMENT
~-It/7r C':'il-rq-m
3/14/(';0
, COMMON PLEAS No.
Notice is ~iven that the appellant has iiled' in the aQave Caurt af Camman Pleas an appeal fram the judgment rendered by the DiStrict Justice on the
date and io the case . mentioned ~I!>V<
CV 12
LT 19
This, black will be signed ONLY when this. f1()tation is requiiedu!)der Po. R.G.PJ.P. N"
10~a ' '
This Nalke . of Appeal, when received by the District Justice, will coperate as a
SUPERSI,DEAS ta the jud~menf far possession in this case. .
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SIGNATURE OF APpalANT
ZIP CODE
17013
t'eOfAPI'WANT
HU(tA.J(\ ChiiD
AIXlIESS,Qf APPEUANT' "
\ '~c.uJn. st
DATE OF AJDGMfNT
at-aal- ex')
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Uo -Chil 'i.idtLfls,<;;6~-t
appell' was CLAIMANT (see Pa. R.CP.JP. No.
toO 1 (6i,i"fJ~ction bef,()f,e Oilltt:ict Justice, he MUST
FILE A COMPLAINT within' twenty (20) days after
filing his NOTICE of APPEAL.
, '"
of 'Prothonotary or peputy
',,' \ '
"PRAECI 1 < I\,lTER lULETO FILECOMPLAINl AND RULE lOFILE
(ThIs secthm of torrri.to.be iJsiID ON~Y'When ~lIant was DEFENDANT (see Pa. HC.P.J.P. No. 1001(7) in action before District Justice,
fF NOT IJSED, detac;h from copy of ndtice of appea/kJ be served upon appellee),
PRAECIPE: TaProthonatary "
Name of appellee(s)
i appellee(s), ta file a camplaint in this appeal
Enter rule upon
(Cammon Pieas No.
) within twenty (20) days after service of rule or suffer entry af judgment af nan pros.
, ,""''''
sigJiature of appenant" or his attOrney or agent
RULE: Tl)'
Name at aWe/Joers)
, appellee(s).
, .' ",,', ' . ',"
" ',' ,.
(l) You are natilled ~I:!;i:rule ishereby entered upon yau ta fileacamplaint in this appeal within twenty .(20) daysofter:'h~dale af
service 'of this::~,I,e ~,:you ~&rsonal service or by certified or regis~d,mail. _ _. ,'_ ':, "/":3'(", "
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(2) If YOU' do ntit file "::"""plaint within this time, a JUDGMENT OF NON PROS WILL BE ENTERED AGAllo,lST YOu.
(3) The dateaf service af this rule ifservice was by mail is the elale of mailing.
Date:
,19_.
Signature at I'roltIonoIwy or DepuIy
-
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PDPC 312.84
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PROOF OF SERVICE OF NOTICE OF APPE,/),L AND RULE TO FilE COMPLAINT
(This prooi of service MUST BE FfLED WITHIN TEN (10) DA YS AI'TER filing the notice of appeal. Qheck applicable boxes)
COMMONWEALTH OF PENNSYLVANIA
.r'? 1'/'
COUNTY Of rTt1J1 g t /1/
;..
AFFIDAVIT: I hereby sweilr or affirm that I served
o a copy of the Notice of Ajpeal, Cor,nmon Pleas No. ,;/1XjO - /'frFg' , upon the Distri9,t->L~lice designated therein on
(dete a/service) ,'/i"-t)O. ,DqbYlfersonalJerVice ftl by K~!i!i.~,l) (registered) mail, sender's
rec.lJjpt atl?ched hereto. and upon the appellee, (neme) l.p 'hUf' t) eel< , on
//;t1fC/fl ,ill:- ,).g~ 0 by personal service JL1 by((2;rtiiiedl"(registered) mail, sender's receipt attached hereto,
and further that I serveelthe Rule to File a Complainl accompanying ihe above Notice of Appeal upon the appellee(s) to whom
the Rule was addressed on _, 19~ 0 by persqnal service 0 by (certified) (registered)
mail, sender's receipt attached hereto, . " ----"
SWORN (AFFIRMED) AND SUBSCRIBED BEFORE ME
~ .'
THIS Q.l S DAY OF (11€- relt ,1il ~MC
'cJ~ K CcJJ4'
Signature of ofti laj before whom affidavit was made
ill D +<tI~ 1
Title ofofficiai
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Slit nature of affiant
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My commission expires on
,19--
NOTARIAL SEAr, J
LINDA H. EAKLE, No,"."" .
Bora of Chambcrsburg, F.~,
:My Commission Expires October ~'. ~;jQQ
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