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COMMONWEALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
Judicial District, County Of
NOTICE OF APPEAL
FROM
DISTRICT JUSTICE JUDGM//ENT p
COMMON PLEAS No. O ~ ' CJ ~ ~ 1 GNt
NOTICE OF APPEAL ~~
Notice 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 date and in the case referenced below.
NAME OF APPELLANT
t~D(~err ~-.iv~rt9 ~~II
C~en~-ti^ MAG. D15T. NO.
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DATE OF JUDG
~] ~ 1 3~ NT
U'7 IN THE CASE OF (Plantilrl ~ ,
~o~c,cn ~-t Ill ng C~-+~'~c.r ,~ (t~rendantl
Er~-l, ~ur~i5t
ET, f~L,'T
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This block wil! tie signed ONLY when this notation is required under Pa.
R.C.P.D.J. No. 10088.
This Notice of Appeal, when received by the District Justice, will operate as a
SUPERSEDEAS to the judgment for possession in this case.
Signature d Prothonotary a Osp~Ry
~~~
appellant was Claimant (see Pa. R.C.P.D.J. No. 1001(6) in action
before a District Justice, A COMPLAINT MUST BE FILED within twenty
(20) days after filing fhe NOTICE of APPEAL.
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This section of form to be used ONLY when appellant was DEFENDANT (see Pa.R.C.P.D.J. No. 1001(7) in acbson before District Justice. IF
N07 USED, detach from copy of notice of appeal fo be served upon appellee.
PRAECIPE: To Prothonotary
Enter rule upon
Name d appegee(s)
appellee(s), to file a complaint in this appeal
{Common Pleas No. )within twenty (20) days after service of rote or suffer entry of judgment of non pros.
Signature of appellant or attorney a agent
RULE: To , appellees)
Name of appeuee(s)
(1) You are notified that a rote is hereby entered upon you to file a complaint in this appeal within twenty (20) days after the date of service
of this rule upon you by personal service or by certified or registered mail.
(2} If you do not fife a complaint within this time, a JUDGMENT OF NON PROS MAY BE ENTERED AGAINST YOU.
(3) The date of service of this rule if service was by mail is the date of the mailing.
Date:
,20
Signature oI Prottronotary or Deputy
YOU MUST INCLUDE A COPY OF THE NOTICE OF JUDGMENTfTRANSCRIPT FORM WITH THIS NOTICE OF APPEAL.
AOPC 312-02
WHRE -COURT FILE TO BE FILED WRH PROTHONOTARY GREEN -COURT FILE YELLOW -APPELLANTS COPY
PINK - COPY TO BE SERVED ON APPELLEE GOLD -COPY TO BE SERVED ON DtSTRICi JUSTICE
PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
(This proof of service MUST BE FILED WITHIN TEN (10) DAYS AFTER filing of the notice of appeal. Check applicable boxes.)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ; ss
AFFIDAVIT: I hereby (swear) (affirm) that I served
^ a copy of the Notice of Appeal, Common Pleas
upon the District Justice designated therein on
(date of service) , 20 ^ by personal service ^ b
y (certified) (registered) mail,
sender's receipt attached hereto, and upon the appellee, (name)
on
20 ^ by personal service ^ by (certified) (registered) mail;
sender's receipt attached hereto.
(SWORN) (AFFIRMED) AND SUBSCRIBED BEFORE ME
THIS DAY OF 20
Signature o/ official before whom affidavit was made
Title of official
My commission expires on 20
Srgnature ofaffi~ant
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• • r'~' NOTICE OF JUDGMENT/TRANSCRIPT
~ 'CC~lIMONWEALTH OF PENNSYLVANIA CIVIL CASE
r+ni inrTV n~• 'CUMBERLAND
PL/~INTIFF: NAME and ADDRESS
~GOLDBM LIVING CErITER
770 POPLAR CHURCH ROAD
..CAMP HILL, PA 17011
L, J
vs.
DEFENDANT: rvnME and ADDRESS
~
rERTBL,, DORCAS, ET AL.
12 6 PLBASA'IDiT TERRACE
~" NEAP CUMBE$,LAND, PA 17 07 0
_ `~.. L J
60L> IVING CENTER
770,~~pPO~ CHURCH ROAD Docket No.: CV-0000167-07
CAM H~L, PA 17011 Date Filed: 6/20/07
vsv
. , ~; ~ `.
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THI IS TO NOTIFY YOU THAT: ERTBL, DORCAS DI3F+ 001
DIS1[ISSED ~/O PRBJIIDICB (Date,of Judgment) ;..~._ .9/13/07.... __ - _ _ . __ .
. -~,: __ .. ~ Judgment:.... :
~' Judgment was entered for: (Name)
Judgment was entered against: (Name)
in the amount of $ , __ _.___, _l ,.._,_,,,,,,,„a x . 00
Defendants are jointly and severally liable. Judgment Costs ~ ' "
.Interest on Judgment $
Damages will be assessed on Date & Time Attorney Fees $
y ,
This case dismissed without prejudice. Total $ . 00
Amount of Judgment Subject to Attachmend42 Pa.C':S. § 8127 ,Post Judgment Credits
$ Post Judgment Costs $___ _______
Portion of Judgment for physical damages arising out. of Certified Jud merit Total $
residential lease 9
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ANY PARTY HAS THE RIGHT~TO AP ~ EAL~ITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE
OF`APPEAL WITH THE PROTi~NOY/CLERK OF THE COURT OF COMMON PLEAS, CIVIL DIVISION. YOU
MUST INCLUDE A COPY OF TyIS N07~'ICE OF JUDGMENT/TRANSCRIPT-FORM WITH YOUR NOTICE OF APPEAL.
EXCEPT AS OTHERWISE l~f{pVIDED IN THE RULES OF CIVIL PROCEDURE FOR MAGISTERIAL DISTRICT JUDGES, IF THE.
JUDGMENT HOLpER ELECTS:O ENTER THE JUDGMENT IN TWE COURT OF COMMON PLEAS, 'ALL FURTHER PROCESS MUST
COME FROM THE C(gUFiT~OMMON'PLE14S ANDS IVO FURTHEft~PROCESS INaY~$ETSSUE[~`$Y THE'MAGISTERIdL~'iISTR1Cfi JUDGI=`: `
UNLESS THE JUDGME IS; ENTERED IN THE COURT OF COMMON RLEAS, ANYONE INTERESTED IN THE JUDGMENT A(IAY FILE ,;!
A REQUEST FOR ENTRY OF S~ICTI$FACTION WITH THE MAGISTERIAL DISTRICT JUDGE IF THE JUDGMENT DEBTOR PAYS IN FULL,
SETTLES, OR OTHERWISE CC3 IMPLIES WITH THE JUDGMENT.
,,~
Dam'` ,Magisterial .District ;Judge
... .
;, I certify that his is a,true and ca ect'copy th oft e p edings containirig the judgmenf:
Date ,Magisterial District Judge
My commission expires first Monday of January,
AOPC 315-07
DATE PRINTED:
2012
9/13/07 10:54:00 AM
SEAL
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