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COMMONWIALTH 0' 'INN SYLVANIA
couaY 0' COMMON 'LIAS
NOTICE OF APPEAL
fROM
Cunber~~teY
DISTRICT JUSTICE JUDGMENT
, l /) "/1 T 4/Wo.o..,
COMMON 'LIAS No. q !J - 5" t.f.,.. ( ~
NOTICE OF APPEAL
Notice i. given that the appellant has filed in the abaYe CaUft of Common Plea, an appeal from the judgment rendered by the Di.trict Ju.tice an the
dale and in the COWl mentioned below.
Karen A. Carignan, Ronald G. Carignan and Nancy L.
Cari a Gr 's Nurse
NA
09-3-05 Ronald E. Klair
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Pike Mechanicsbur
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lvania
17055
Karen A. Carignah"':1Ohald G. Carignan
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LIlt: APt LLAHT i1B"l'TOI~y 01 ICrm '7" .. -;7
~ Nursery
11 appellant was CLAIMANT (see Pa. R.c.P.J.P. No,
1001 (6) in action belore District Justice, he MUST
FILE A COMPLAINT within twenty (20) days after
filing his NOTICE of APPEAL.
Thanas B. York
CV 19. -251-95
LT 19
This black win be signed ONLY when this notation i, required under Po. R.cP JP. No.
looB8.
Thi. Notice of Appeal, when recei...d by the Di,trict Ju.tice, will operate a. a
SUPERSEDEAS ta the judgment far po..e..ian in this ca...
Signature aI Prothonotary or Deputy
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This seetlon 01 frxm to be used ONLY when appellant was DEFENDANT (see Po, R,C.P.J.P. No. 1001(7) in action belore District Justice,
IF NOT USED. detach Irom c",y 01 notice 01 appeal to be served upon appellee),
PRAECIPE, To Prothonotary
Enlet rule upon ThrfMq B Vnrk . appellee(.}. to file a complaint in this appeal
_oJ_.,
(Common Pleas No. q 5 -.5"'lh:i1 U>>.1 TfA..-- ) within twenty (20) day. of non pros
RULE, To
'J'hnn;,q B Vnrk
Name oJ _'J
. appeItee(.),
(1) You are notified that a rule i, hereby entered upan you to file a c~int in this appeal within twenty (20) days after the date of
_vice of this rule upon you by personal service or by certified ar regi.tered mat1
(2) If you da not file a complaint within this time. a JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOU.
Date:
131 The date of -vlCe of thi, rule if service wo, by mail i. the date of mailing.
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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 (101 DA YS AFTER filing the notice of appeal. Chack applicab/a baKes)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF -,
; II
AFFIDAVIT: ereby swear or affirm that I served
ril a copy 01 the Noticq 01 Appeal. Common Pl<<:as No, '15'- 5'44--1- ' upon the District Justice designated therein on
(date 01 service) ~h.,\'?"., II ,19~. 0 by personal servlFe y (certllled) ("'!II.to,ad) mall, sender's
receipt attached hereto, and upon the appellee, (name) , on
(It:\t.l<>t~, 1\ .19'1';;- n by personelservlce ~by (certified) (.eg:_I/..ed) mail, sender's receipt attached hereto,
\Xl and further that I served the Rule to File a Complaint accompanying the above Notice of Appeal upon the appellee(a) to whom
the Rule was addressed on tv ~ (..~ .- II ,19.22: 0 by persons I service f.!I.by (certiffed) (reall'lfed)
mall, sender's receipt eUached hereto,
SWORN (AFFIRMED) AND SUBSCRIBE? BEFOR~M,;....
THIS--J\. ~ DAYOF"t)&~~~ '
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SIgnature at affiant
~b.~ whom .II'd."'....m.d.
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Title 0' O"'Clal ~
My commission expires on
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Notsrlsl Seal
Deborah L, Grsha'!'J Notal'( Public
Dillsburg Boro, york County
My Commisslon Expires Jan, 2. 1999
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RECEIPT FOR CEI'TIFlr:J MAil
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