Fillable Appealfromarbitrationaward DELAWARE COUNTY COURT OF COMMON PLEAS

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Appealfromarbitrationaward DELAWARE COUNTY COURT OF COMMON PLEAS

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BROWSE DELAWARE COUNTY COURTHOUSE AND GOVERNMENT CENTER (PA) FORMS

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DELAWARE COUNTY COURT OF COMMON PLEAS
APPEAL FROM ARBITRATION AWARD
CASE CAPTION: NO.___________________
TRIAL DATE: _________________
AWARD DATE: ________________
APPEAL DATE: ________________
COMPANION CASE (IF ANY)
Notice is given that (party's name): ________________________________________________
appeals from the award of the board of arbitrators entered in this case.
A jury trial is demanded. (Check box if a jury trial is demanded. Otherwise jury is waived,
see Pa. R.C.P 1007.1 (b).)
I hereby certify that: (check one box)
the compensation of the arbitrators has been paid, or
application has been made to proceed in forma pauperis.
Plaintiff's Attorney Defendant's Attorney
____________________________________ ______________________________________
Name Name
____________________________________ _____________________________________
Address Address
____________________________________ ______________________________________
____________________________________ ______________________________________
____________________________________ ______________________________________
Phone Phone
____________________________________ ______________________________________
Name Name
_____________________________________ ______________________________________
Address Address
_____________________________________ ______________________________________
_____________________________________ ______________________________________
_____________________________________ ______________________________________
Phone Phone
*
Include additional names and addresses on back of form.
Name and address of any Unrepresented Party: ___________________________________________________________
__________________________________________________________________________________________________
Signature: __________________________________________________________________Date:____________________
INSTRUCTIONS: This form must be completed in its entirety. No affidavit or verification is required. File in triplicate with the Office
of Judicial Support. File separate appeal forms for each companion case.
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Appealfromarbitrationaward DELAWARE COUNTY COURT OF COMMON PLEAS

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Completed 6 November 2019

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