Fill and Sign the Praecipe for Writ of Certiorari Montgomery County Pa Form

AOPC 25-05 COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS Judicial District, County of WRIT OF CERTIORARI TO MAGISTERIAL DISTRICT JUDGE COMMON PLEAS No. PRAECIPE FOR A WRIT OF CERTIORARI NAME OF P ARTY FILING THIS PRAECIPE AND OBTAINING THIS WRIT DOCKET No. DATE JUDGMENT RENDERED IN THE CASE OF (Plaintiff) vs. (Defendant) The party named above claim that with respect to the above proceedings there was: (Check applicable box or boxes) lack of jurisdiction over the subject matter lack of jurisdiction over ________________________________________________ (Name of party) improper venue such gross irregularity of procedure as to make the judgment void PRAECIPE: To the Prothonotary Issue a Writ of Certior ari directing ,Magisterial District Judge, to transmit to you a certified true copy of the record of the proceedings n\ amed above. _____________________________________________ (Signature of party filing praecipe or attorney or agent) WRIT OF CERTIORARI TO: , Magisterial District Judge 1. You are hereby directed by this writ to transmit to the Prothonotary of this Court of C\ ommon Pleas, within ten (10) days after you receive this writ, a certified true copy of the record of the \ proceedings named above. 2. This writ, wh en received by you, will operate as a SUPERSEDEAS to the judgment for possession in this case. This block will be c hecked ONLY when this notation is required under Pa.R.C.P.D.J. No. 1013B. Date delivered for service , 20 . _____________________________________________________ (Signatu re of Prothonotary or Deputy) COURT FILE PROOF OF SERVICE OF WRIT OF CERTIORARI (This proof of service MUST BE FILED WITHIN FIVE (5) DAYS AFTER deliv\ ery of the writ for service) (Check applicable boxes) _________________ ______ __________________________________________ I hereby certify that I served the Writ of Certiorari, Common Pleas No. _____________________ , upon the Magisterial District Judge to whom it was directed on _____ , 20 _____ , by personal service, or certified or registered mail, sender’s receipt attached hereto. I verify that the statements herein are true and correct. I understand that false statements herein are made subject to the penalties of section 4904 of the crimes code (18 Pa.C.S. § 4904), relating to unsworn falsification to authorities. By: ______________________________ Name ______________________________ Signature Date: ____________________________