Instructions for:
Form 12
Praecipe to Transmit the Record
Form 12 - Praecipe to Transmit the Record
The numbers on these instructions correspond with the numbers in the arrowboxes on the
form. Use the form with the arrowboxes to guide you through filling out the blank form.
1. Write the name of the county you are filing in by arrowbox 1. Write exactly what
you wrote on Form 1, by arrowbox 1.
2. Write the name of the Plaintiff by arrowbox 2. Write it exactly as it appears on
Form 1, by arrowbox 2.
3. Write the name of the Defendant by arrowbox 3. Write it exactly as it appears on
Form 1, by arrowbox 3.
4. Write the docket number by arrowbox 4. The docket number is the number that
the Prothonotary's Office wrote on Form 1, by arrowbox 4 at the time of filing.
5. Circle either 3301(c) or 3301(d), depending on the type of divorce you are
seeking.
6. Write the date that Form 1 was served by arrowbox 5. This date will be on either
Form 3-A (the date your spouse signed the Acceptance), 3-B (the date your
spouse signed the green card), or 3-C (the date a third party handed your spouse
Form 1), depending on which form you used for service.
7. Write the method of service by arrowbox 7:
If your spouse accepted Form #1 from you and signed Form 3-A, write:
"acceptance" by arrowbox 6.
If you mailed Form #1 to your spouse by certified, restricted delivery, and
filed Form 3-B, write: "certified, restricted, return receipt requested United
States mail" by arrowbox 6.
If a third party, not you (ex/ the Sheriff), handed Form #1 to your spouse and
completed Form 3-C, write: “personal service” by arrowbox 6.
If you are doing a 3301(c) consent divorce, complete the following:
8. Write the date Plaintiff (the person by arrowbox 2) signed Form 5-A (Affidavit of
Consent) by arrowbox 8.
9. Write the date Defendant (the person by arrowbox 3) signed Form 5-B (Affidavit
of Consent) by arrowbox 9.
10. Leave arrowbox 10 blank.
11. Leave arrowbox 11 blank.
12. If you have no other pending claims (such as a Petition for Special Relief or any
other economic claim), write “no claims pending” by arrowbox 12.
If you have completed, signed, and filed an agreement between the two parties
settling your economic claims, and within the document itself it states that the
parties wish to incorporate, but not merge, the agreement, then by arrowbox 12
write: the name of the document, the date it was signed, that the parties wish to
“incorporate but not merge” the document, and the paragraph number within the
document or other indication of location requesting the incorporation.
If you have a Petition for Special Relief pending, write the name of your petition
and a brief description of the claim by arrowbox 9 and attach a copy of your
petition to the Praecipe.
A ____ OR B________________
If filing Waivers - If serving a Notice of Intention -
13. Leave line 13 blank.
14. Leave line 14 blank.
15. Write the date the Plaintiff (the person
on line 2) filed (time stamped) Form 6-A
(Waiver of Notice) in the Prothonotary’s
Office by arrowbox 15.
16. Write the date the Defendant (the
person on line 3) filed (time stamped) Form
6-B (Waiver of Notice) in the
Prothonotary’s Office by arrowbox 16.
13. Write the date you served Form 7
(Notice of Intention to Request Entry of
Section 3301(c) Divorce Decree/Counter-
Affidavit) by arrowbox 13. (See Form 11
for date of service.)
14. Write how you served Form 7 by
arrowbox 14 “First Class Mail.”
15. Leave arrowbox 15 blank.
16. Leave arrowbox 16 blank.
17. Write the date you sign this document by arrowbox 17.
18. Sign your name by arrowbox 18, indicate whether you are the Plaintiff or
Defendant.
19. File this form with the Prothonotary.
If you are doing a 3301(d) non-consent divorce (2 years of separation),
complete the following:
8. Leave arrowbox 8 blank.
9. Leave arrowbox 9 blank.
10. Write the date you signed Form 8 (Affidavit Under Section 3301(d)) by arrowbox
10.
11. Write the date you served Form 8 by arrowbox 10. (See Form 11 for date of
service.)
12. If you have no other pending Petitions (such as a Petition for Special Relief),
write “no claims pending” by arrowbox 12.
If you have completed, signed, and filed an agreement between the two parties
settling your economic claims, within the document itself it states that the parties
wish to incorporate, but not merge, the agreement, then by arrowbox 12 write: the
name of the document, the date it was signed, that the parties wish to “incorporate
but not merge” the document, and the paragraph number within the document or
other indication of location requesting the incorporation.
If you have a Petition for Special Relief pending, write the name of your petition
by arrowbox 9 and attach a copy of your petition to the Praecipe.
13. Write the date you served Form 9 (Notice of Intention to Request Entry of Section
3301(d) Divorce Decree) by arrowbox 13. (See Form 11 for date of service.)
14. Write how you served Form 9 by arrowbox 14 “First Class Mail.”
15. Leave arrowbox 15 blank.
16. Leave arrowbox 16 blank.
17. Write the date you sign this document by arrowbox 16.
18. Sign your name by arrowbox 17 and indicate whether you are the Plaintiff or
Defendant.
19. File this form with the Prothonotary.
Form 12
Page 1 of 2
IN THE COURT OF COMMON PLEAS OF
_______________________ COUNTY, PENNSYLVANIA
_______________________________, : CIVIL ACTION LAW
PLAINTIFF :
:
: Case No. ______________
vs. :
:
_______________________________, :
DEFENDANT : IN DIVORCE
PRAECIPE TO TRANSMIT RECORD
To the Prothonotary:
Transmit the record, together with the following information, to the Court for
entry of a divorce decree:
1. Ground for divorce: Irretrievable breakdown under Section 3301(c) or 3301(d) of the
Divorce Code.
2. Date and manner of service of the Complaint: ________________(date of service);
_________________________ (method of service).
3. Complete either paragraph (a) or (b).
(a) Date of execution of the Affidavit of Consent required by Section
3301(c) of the Divorce Code: by Plaintiff _________________
(date Plaintiff signed); by Defendant ________________ (date
Defendant signed).
(b) Date of execution of Plaintiff’s Affidavit required by Section
3301(d) of the Divorce Code:______________(date Plaintiff
signed); Date of service of Plaintiff’s Affidavit upon Defendant:
________________ (date of service).
1
2
3
4
5
6
7
8
9
10
11
Form 12
Page 2 of 2
4. Related claims pending: ________________________________________________.
5. Complete either (a) or (b).
(a) Date and manner of service of the Notice of Intention to file
Praecipe, a copy of which is attached: ______________ (date of
service); ________________________(method of service).
(b) Date Plaintiff’s Waiver of Notice was filed with the Prothonotary:
____________ (date filed). Date Defendant’s Waiver of Notice
was filed with the Prothonotary: ____________ (date filed).
Dated: _______________ _________________________________
( )Plaintiff
( )Defendant
12
13
14
15
16
17
18
IN THE COURT OF COMMON PLEAS OF
_______________________ COUNTY, PENNSYLVANIA
_______________________________, : CIVIL ACTION LAW
PLAINTIFF :
:
: Case No. ______________
vs. :
:
_______________________________, :
DEFENDANT : IN DIVORCE
PRAECIPE TO TRANSMIT RECORD
To the Prothonotary:
Transmit the record, together with the following information, to the Court for entry of a
divorce decree:
1. Ground for divorce: Irretrievable breakdown under Section 3301(c) or 3301(d) of the Divorce
Code.
2. Date and manner of service of the Complaint: ________________(date of service);
_________________________ (method of service).
3. Complete either paragraph (a) or (b).
(a) Date of execution of the Affidavit of Consent required by Section 3301(c)
of the Divorce Code: by Plaintiff _________________ (date Plaintiff
signed); by Defendant ________________ (date Defendant signed).
(b) Date of execution of Plaintiff’s Affidavit required by Section 3301(d) of the
Divorce Code:______________(date Plaintiff signed); Date of service of
Plaintiff’s Affidavit upon Defendant: ________________ (date of service).
4. Related claims pending: ________________________________________________.
5. Complete either (a) or (b).
(a) Date and manner of service of the Notice of Intention to file Praecipe, a
copy of which is attached: ______________ (date of service);
________________________(method of service).
(b) Date Plaintiff’s Waiver of Notice was filed with the Prothonotary:
____________ (date filed). Date Defendant’s Waiver of Notice was filed
with the Prothonotary: ____________ (date filed).
Dated: _______________ _________________________________
( )Plaintiff
( )Defendant