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NOTICE OF APPEAL
COMMONWIAUH O' P1NNIYlYANIA
couila, COMMONPilAI
fllOM
IUPICIAI DIIl.ICI
DISTRICT JUSTICE JUDGMENT
COMMON'IUlNa qLI. .f391 C,t~11 T,rm
NOTICE OF APPEAL
Nolk. II gi_ lhollh. ol'pellonl hOI filed in the above COUll of Cammon 1'1.01 an 0flI'.01 from ,h. Judgment r.nd.,.d by Ih. Oilhkl JUllit. an the
date md In lhe COl. mentioned below.
NAMlOf_,llIll.. Krlslle IIIB.I"r fly"r:.~..~--~._._-~_-d .rAO~:~~,~~~Ml~::\:~,~;
IJilimI1ifAPlf,fiMf. em IlAII IHl'llr
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Thil b1ac~ will b. ligned ONLY willn 1101 nololloo II t.quirod und.. Po RCJl:JP Na 111/I.VlUllilnl WiI& CLA/MAN! (fua Pa IIG !'JP No.
10088.
Thll Nolie. of Appeal, willn re,eived by 'Ill Oi.llkl JUlli,", will Oflorole UI n IOOI(6) /II olellm he/om [llstflet Jusllee,/,e MUST
SUPERSEDEAS Ia lhe judgmenl fot polI.1l1an In Ihil [(III f II [ A COM!'I A/NT wllllin twenty (20 J Ij,lYS /liter
_.____ III/ng /1/& NO liCE 01 A!'I'E AI.
---'.S;gtl'lrUm 0; i1mlhOfllllillv ,.... Ilf'lloly
. PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This sec/Ion 01 101m to be usod ONL Y wl,OI1 a/llellalll Wi" Illf (NIlANI (WI' I'" 11(; 1',/1' No 'CKJ/( 7) "' ad"., 1",llMO D"'lIct .Iosl,,:e
IF NOT USED, dc/JJcll III." CI,lY 1I/1I0t/CO 0111/')(1,11 to hI! &1'/1"/111".' ..,,"'111'1')
'IAECIPE, To PralhonalOlY
Enl.. rule UflDl1 n . ..
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(Common pleol Na 33 q I
Hol,,' rl K 11'111, h
. nppell..lll. 'a fII. a (OI.tplo..1 In I"'. "",",01
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I wllI"n lwenly 1101 duy. all.. "",,,.01 ,ule 01 .ulf.. ..Ihr of Judgmem of non ""'l
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J1 Sr(l'lifflltO tJ'/ttHMwtf IN t? ~~~ (If .....
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(II You are nallfted Ihol a rule I. h_by ..,tOt.d upon you to file a 1""1~nint In 1101 app.a1 wllhil1lweflly (20) day. all.. the dale 01
...vIc. allhllcule upon rou by pec.DtlOI....k. or by ,..tilled 01 l.gi.I...d n..11
(2)<< you do flol file a camplalnt wnIMn 1101 lime, a JUDGMENT OF NON PROS Will BE ENTERfD AGAINST YOU.
(3) The dal. 01 lI..k. 01 thIl rule If ....k. WOI by mall II the dole af /IllIiling
Oato:_gllAll- ~ '191J~-IlLJatiw'~-t;"'i.~..~iiir
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Other:
(f) Oebte and obligations
Mortgllge: _ _.llJA... _____
Rent: . .hQ..~.cLP.iLlilllh . U j Yj.lui1.th.Jaf~t.Jl___
LoanB: Clf I oon.1 00 ,OO/!IlJomttJIY: PgrllQnAl JgAn_Ull.4,Q~_
Month I y El<penses: QfoCflf 1 ell (notcQy.uvd In fOQg l!tllmt:!IIJ
UOll.QQi TllhwtJ9nll J40.QQi EIQctr1c,: UO.QQ.i~1J1r~[
UQ, 00 j J I)synmcfI f Of CAf '!l~. 00 j M111~~!!1Ul!illllIULJ.ll,-01l
(g) Persons dependent upon you for support
(W i fa) (Husband) Name: .NJA____________.___.____
Children, if any:
Name: GI1VOIe!:!f MVIJfll Age :____.LU.I_.__________
~. I understand that I have a continuing obligation to
inform the court of improvemsnt in my financial circumstancee
which would permit ms to pay the costs incurred herein.
6. I verify that the statements made in this affidavit
are true and correct. I understand that false Btatsments herein
are made subject to the penalties of 16 Pa, C.B. 4904t relating
to unsworn falsification to authoritiElB.
_0_...__.... .. .._._ __.__.________.___
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