Fill and Sign the Pennsylvania Civil Form

CIVIL COVER SHEET AND ENTRY OF APPEARANCE ______________________ County Court of Common Pleas 1. Case Caption:       Court Term & No. Jury Non Jury Arbitration $ 450,000 2a. Plaintiff(s) (Name and address)       2b. Defendant(s) (Name and address)                                                                   3a. Related Cases? Yes No 3b. Case Subject to Coordination Order? Yes No If yes, show Caption and Case Numbers If yes, show Caption and date of Order             4. Entry of Appearance To the Office of Judicial Support: Kindly enter my appearance on behalf of _____________________________________ , (a) plaintiff in this action. Papers may be served at the address set forth below. _____________________________________ Address: _____________________________________ Attorney for party named above ( Please print) _____________________________________ _____________________________________ _________________________ Attorney I.D. Number Telephone: ( ____ ) __________ Fax: ( ____ ) __________ Email: _____________________________________ _________________________________________       Attorney Signature Date The second page must be completed Civil Cover Sheet - 1 - Choose only the one description which best reflects the principal type of case or relief sought from the list. Case Description APPEAL International Tort Minor Court Assault and Battery Money Judgment Libel and Slander Landlord and Tenant Defamation Code Enforcement Employment/Wrongful Discharge Personal Injury False Imprisonment Breach of Contract Fraud Other       Malicious Prosecution Negligence Local Agency Motor Vehicle Civil Service Real Property Motor Vehicle Premises Liability Licenses and Inspections Product Liability Liquor Control Board Toxic Tort Tax Assessment Boards Asbestos Zoning Board DES Other       Implant Toxic Waste Proceedings Commenced by Petition Other       Appointment of Arbitrators Professional Malpractice Change of Name Dental Compel Medical Examination Legal Election Matters Medical Eminent Domain* Other       Leave to Issue Subpoena Equity Mental Health Proceedings Real Property Other       Stockholders Derivative Action Waste Prevention CIVIL ACTIONS COMMENCED BY WRIT Other       OF SUMMONS OR COMPLAINT Declaratory Judgment Ground Rent Abuse of Process Mandamus Action for Wrongful Death Real Property Class Action Ejectment Confession of Judgment/Money Quiet Title Confession or Judgment/Money (Real Property) Mortgage Foreclosure Contract Mechanics Lien Construction Partition Insurance/Bad Faith Prevent Waste Negotiable Instruments Replevin Other       Saving Action Urn/Uirn Quo Warranto Other       Civil Cover Sheet - 2 -