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COM~...WIALTH 0' 'INNSYLYANIA
COUIT 0' COMMON PLEAS
NOTICE OF APPEAL
JUDICIAL DIS'.IC'
fllOM ~ / I if 'I /
DISTRICT JUSTICE JUDGMENT
COMMOH'LEAS H~ q / _ <.../ t ~.~.. ('.4. t ,,' r., t..
NOTICE OF APPEAL
Noliee i. gi"", that the oppeIlant has liled in the above COutt 01 Commol1 Plea. on appeal ltam the Judgment r.roe.ed by the 0.'1"<1 Juttic. on tho
dole CIld in the case ,"""1;',,,..1 be'-
f)FJYIiXc"V V}/IFcRm ~).INE1'J S",Pf'J.'I.3:Nf.. () /v__Jt..t::"1!~TIt-C!T 1-.t7e,CJe~:JL_________ _ __ _
NAMf~ MAUV!)rNOOI'NAMt:urO,
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This bIod wit be signed ONlY when this notation i. requited under Po. R(!fiNa If appellant was CLAIMANT (see Pa, RCP.JP. No
10088-
This Notice 01 Appoof. when roce<ed by the Di.trict Justice. wiD operole en 0 1001(6) Ifl actKX1 beloreDtstTlC1 JusllCe, he MUST
SUPERSEDEAS ta the jucfsment lot pouession in 1M <me. FILE A COMPLAINT Wlthtn twenty (20) days all(Jf
IiIIng hts NOTICE of AP.P.EAL
$y1.1ture of _y""r,;-o."""y--"--"-----
PRAECIPE TO ENTER RULETOFiLECOMpLAINTAND-iuLE TO FILl
(This sectjgn 01 /otm 10 be USOO ONLY when awell.1I1t was DCffNDANT (Sf}(> Pa RCPJP No 1001(7 J "' actUl Ix",-"" 0IsIr1Ct Justn'
IF NOT USED. detach from cwy 01 notICe 01 aweat 10 be served t.poo aweIIec J
PRAECIPEI To Prothanolaty
Entet ... upon
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RULlI To
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...woe of ....... upon you by ,*","",....a tit by comfiecI tit ,..~.I_.d moil
121' you do not fio a ....... ' .~ wiIhiR.... 1irN. 0 Jl.IOOMENT Of NON PIlOS WUIE ENTflfD ~T ~.
(3) The .... of ....a of lhis """ I Mr. _ by IIlOi is "" .... of mailing.
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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
(Th,s proal 0/ semce MUST BE FILED WITHiN TEN 110! DA YS AFTEr! t.l.ng the not,ce 0' dpped/. Check appl,c.ble bO,es)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ; II
AFFIDAVIT: I hereby swear or affirm that' served
~ a copy ot the Notice of Appeal, Common Pieas No. . upon the District Justice designated therein on
(date a/service) ,19_ 0 by personal service 0 by (Cefllfled) ireglstered) mall. sender's
receipt attached hereto. and upon the appellee (name) . on
. 19---D by personal ser\ltce 0 by (Cerhfled) (registered) mati, sender's receipt attached hereto
o and further that I served the Rule to File a Complaint accompanying the above Not.ce ot Appeal upon the appellee(s) to whom
the Rule was addressed on , 19_ 0 by personal service 0 by (cerhlled) (registered)
mall. sender's receipt attached hereto
SWORN iAFFIRMED) AND SUBSCRIBED BEFORE ME
THIS
DAY OF
. 19_
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