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COMMONWEALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
NOTICE OF APPEAL
fROM
JUDICIAL DISTRICT
DISTRICT JUSTICE JUDGMENT
COMMONPLEASN.. Q5' -q 35' C-~...:..t T~
NOTICE OF APPEAL
Nolice I. given Ihol Ihe appellont he. filed In Ihe obove Courl of Common Pleo. on appeol from the judgmenl rendered by Ihe Di.trlct Ju.lice on the
date and in the case mentioned belO'H.
NAMf APP[UAf'{t
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DATE NT Iltf It. fjl'f.IIfWI'1J
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NATURE Of APPtllANT OR HIS AI(OflNEY OR AGENT
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Thl. block will be signed ONLV when this notolion I. required under Po. R.c.PJ.P, No. If appellanl was CLAIMANT (see Pa. R.c.P.J.P. No.
100BB.
Thi. Notice of Appeol, when received by Ihe Ol.trict Ju.tice, will operote 0'0 1001(6) In aclionbelore District Juslice, he MUST
SUPERSEDEAS to the judgment for po..e..lon in thl. co... FILE A COMPLAINT wi/hln twenty (20) days after
filing his NOTICE of APPEAL.
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Sign.1turo of Prothonotaty Of Deputy
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This section ollorm to be used ONLY when eppellanl was DEFENDANT (sea Po, R.G.P,J.P. No, 1001(7) In action belore DisUicl Justica,
IF NOT USED, delach from c~y olnotica at eppeel 10 ba selVed upon amallce).
PRAECIPE. To Prothonotory
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Enter Nle upon ..., /f r I /I L: , appellee(s), to file 0 complaint In Ihl. appeol
N.wne at ll/lJCllectsl
(Common Pleo. No. Cj S- -~.35" C~ f~) within twenly (20) doy. oller .er;,::o:ru:~ onu er .:0:;~ non pro.
. L'.} . ~:~;' .. . ~ -,. .,').~ . SifTIiJlllO 01 owclliYlt Of his Dltomcy Of agent
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RULE. To :"; /.' " , / ,oppellee(.), /'
Namo oIl1(fJCllco(s'
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(1) Vou ore notified lhot a rule I. hereby entered upon you to file 0 complolntln Ihl. oppeal within Iwenty (20) day. oller the dote of
service of this rule upon y~~by peu,oool service or by certified or registered moiL
(2) If you do notJil8" 0 coniplolnt within this time, 0 JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOU.
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(3) The dole of .ervice of Ihl. rule if .ervice we. by moll i. the dote of moiling.
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COURT FILE TO BE FILED WITH PROTHONOTARY
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PROOF OF SERVICE OF NOTICE OF APPEJ.\L AND RUU, TO FILE COMPLAINT
(This proal 01 wrvir.o MUST IJE FILED \VITIIIN flVI: (5) fMY,'; Al'IEII fillli;} II'" /lotice of ""pCJ'. CIIl)""' .1pplicnlJlo taxos)
COMMONWEALTH OF PEHNSVLVANI1\
COUNTY OF I ..
AFFIDAVIT: I heroby ,woor or offilm .holl ,nrv.d
o 0 copy of the Nollco of Apponl, CommlJn Plum NO._____._h___h__________. urnn tho District JuslicQ dcslonalcd theroln on
(data 01 sorvlco)_________._, 1'/_, I J by 1'""'''"01 ,""i," 0 by (c",'lflcd) (regl,'",od) mall, sendor'.
rc~clpl ol/(Jchud horulo. nnd upon thu oppolluo, (rwmo)__ , on
_____. 19_____rJ 1,)' prl''\(mal 'mrvlcc Cl h; (rl'fli'icf~) {f~ul:.lcrcd) !na1l, ~cndcr': rccolpl oltochcd herelo.
o und furlhlJf Ilwl I H'rvnd Ihu r?uln 10 FlIi, n Complaint tl:'QHl"fln'{in~J IIH) obo'/o Nollcu of Appoal upon tho appollee(s) to
whom tho RuIn wmodJ,u~~ud Ofl__.__________, 19_, 0 by per~ol1ol ~IH\llct3 0 by (certified) (reolstered)
moll. londer's recelpl olltlcheJ horeto.
SWORN
THIS
(AFFIRMED) AND SUBSCRlOtD CEFORE ME.
DAV OF , 19_
.!olQnlJtut8 oJ ottlc/a! oorolo whom i"idlJ~'lt was mllde
flue 01 oJ/idal
Nrf commission ..plres on
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NOTICE OF APPEAL
COMMONWEALTH 0' P'NNSYLVANIA
COURT OF COMMON PUA'
FROM
JUDICIAL DISTRICT
DISTRICT JUSTICE JUDGMENT
COMMON PLlAS No. 1'1 S
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NOTICE OF APPEAL
Nollee Is given thaI the appellont ha. filed in Ihe obove Court of Common Plea. an appeal hOI11 the judgment rendered by the o;lIricl Ju.tlee on the
dole end In 1110 co.e mentiO"lOd bolOI'<
NAMf Of :'')UAN1 . A /'
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Thl. block will be ~gned ONLY when thl. nolotion I. required under Po. R,CP.JP. No. If appellant WJS CLAIMANT (sea Pa. R.c'p,J.P, No.
1008B.
Thl. Notice of Appeol, when received by the Oi.lrlet Ju.llee, will operale a. 0 1001 (6) in action beforo District Justice. he MUST
SUPERSEDEAS to the judgmenl for pOllelllon in Ihi. co.e. FILE A COMPLAINT within twenty (20) days aI/or
filing his NOTICE of APPEAL.
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SigOl1tUro 01 Prothonotary Of Deputy
.PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
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(This section of/arm 10 be used ONLY when oppel/ani was DEFENDANT fsee PD. n.C.P.JP. No, 1001(7) III action be/olll Dislrlcl Justk;o,
IF NOT USED. dotach from copy 0/ notico of appeal 10 bo served upon appelleo).
PRAECIPEI To Prolhonolory " '
Enter ",Ie upon _ C~ /? /1/1/ r /1 /;. .! . /'1 P , app.Uee(.). to file a complaint in tI., oppeol
Nt"oo oIl11f>t'll'(~sJ \
(Common Plea. No. q 5 - q35 C. u<,,1!. -r.-.l."~) wilhin lwonty (20) doy. after .er(v!~'!.,of_rule or.u er entry J..f lu~.?f I~ Jm>L )
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RULEI To' C;/'>/}/V / /1
N,'YflO 01 awvIICL>( 5 J
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, appellee(.),
(1) y"" ore notified thaI a rule i. hereby entered upon you to file a complolnl in thl. oppeol within twenty (20) day. ofler the dote of
ser....ice of this rule upon you by penonol service or by certified or registered moil
(2) K you do not file a comploinl within Ihi. time, 0 JUDGMENT OF NON PROS WilL BE ENTERED AGAINST YOu.
(3) The date of service of thl. rule If .ervice wo. by moil I. the dole of moiling. ,
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COURT FILE
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Certified Mail
No Insuranco COYlllog~P,oyjdcd
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