Fill and Sign the Self Represented Party Entry of Appearance Assessment Form

SRL Entry of Appearance Instructions Self -Represented Party Entry of Appearance SRL Entry of Appearance Instructions Self -Represented Party Entry of Appearance The numbers on thes e instructions correspond with the numbers in the boxes on the f orm. Use the form with the boxes to guide you through filling out the blank form. Box 1: Print the name of the county in which the case is filed. Box 2: Print the name of plaintiff exactly as it appears on the Complaint. Box 3: Print the docket number that the office where legal pleadings are filed wrote on the Complaint at the time of filing. Box 4: Print the name of the defendant exactly as it appears on the Complaint. Box 5: Check w hether this is a custody c ase or a divorce case. Box 6: Print your name and check whether you are the plaintiff or the defendant. Box 7: If you w ere represented by an attorney in this case, and no longer want his or her representation, check here. The attorney may also complete this section. Box 8: Complete this section with an address and telephone number so that you receive court papers, either from the court or from another party. This address does not need to be your home address. This form m ust be filed, and a copy sent to all parties and attorneys, including an attorney removed from the case. Signature Telephone Numb er Address Fax City, State, Zip Code Da te THE PARTY FILI NG THIS ENTRY OF APPEARANCE MUST PROVIDE NOTICE BY SE NDING A CO PY TO ALL PAR TIES AND ATTORNE YS, INCLUDING THE ATTO RNEY REMOVED FR OM THE CAS E. SRL P a, R.C .P. 1930.8 AOPC 4.18.16 1 IN TH E CO URT OF COM MON PLEA S OF COUNT Y PENNSY LVAN IA 2 Plaintiff : : : 3 No. v. 4 : : 5 5 Defendant : : : CUSTODY D IVORCE ENTRY OF A PPEAR ANC E OF SE LF-REPRE SENTED P ARTY 6 PURSUANT TO Pa. R.C .P. No. 1930.8 I, , Plaintiff or De fendant (check one), represent myself in the within a ction. REMOVA L OR WITHDRA WAL OF COUNSEL OF RECORD (If Applicable) Remove , Esq ., as m y atto rney of record. Withdraw my appea rance for the filing party. Esq. (Prin t name) ID# Signatu re D ATE: I understand that I am under a continuing o bligation to prov ide current contact infor mation to the court, to other self -represented p arties, and to attorneys of record. All pleadings and legal papers can be serve d on me at the address listed below: Print Name 7 8 SRL Pa, R.C.P. 1930.8 AOPC 4.18.16IN THE COURT OF COMMON PLEAS OF ___________________ COUNTY PENNSYLVANIA _______________________________ Plaintiff : : : No.___________________________ v. : : _______________________________ Defendant : : : ___CUSTODY ___ DIVORCE ENTRY OF APP EARANCE OF SELF -REPRESENTED PARTY PURSUANT TO Pa.R.C.P. No. 1930.8 I, _____________________________, ( ) Plaintiff or ( ) Defendant, represent myself in the within action. REMOVA L OR WITHDRAWAL OF COUNSEL OF RECORD (If Applicable) ___ Remove __________________________, Esq., as my attorney of rec ord. ___ Withdraw my appearance for the filing party. _________________________ Esq. (Print name) ID# _________________ _________________________ Signature DATE: _______________ I understand that I am under a c ontinuing obligation to provide current contact information to the court, to other self-represented parties, and to attorneys of record. All pleading s and legal papers can be served on me at the address listed below: _________________________________ Print Name _________________________________ Signature _____________________ Telephone Number _________________________________ _____________________ Address _________________________________ Fax _____________________ City, State, Zip Code Date THE PART Y FILING THIS ENTRY OF APPEARANCE MUST PROVIDE NOTICE BY SENDING A COPY TO ALL PARTIES AND ATTO RNEYS, INCLUDING ATTORNEY REMOVED FROM THE CASE.