Form 9 - Notice of Intention to Request
Entry of Section 3301(d) Divorce Decree
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. Write your spouse's name by arrowbox 5.
6. Count 20 calendar days from the date that you will be mailing this form to your spouse.
Day 1 is the day the form is mailed to your spouse. Write that date by arrowbox 6.
7. If you live in one of the following counties: Allegheny, Beaver, Berks, Blair, Bucks,
Chester, Cumberland, Dauphin, Delaware, Erie, Lackawanna, Lancaster, Lehigh,
Luzerne, Mercer, Monroe, Montgomery, Northampton, Philadelphia, Washington,
Westmoreland, or York, you must call your county’s Court Administrator’s Office,
Prothonotary’s Office, or other related county office to determine what lawyer
referral service to put by arrowbox 7.
If you do NOT live in one of the above listed counties: Write by arrowbox 7:
“Pennsylvania Bar Association – Lawyer Referral Service
Telephone 1-800-692-7375 (PA only)
or 717-238-6715”
8. Sign this form by arrowbox 8.
9. Write the name of the county you are filing in by arrowbox 9. Write exactly what you
wrote on Form 1, by arrowbox 1.
10. Write your name by arrowbox 10. Write your name exactly as you wrote it on Form 1, by
arrowbox 2.
11. Write your spouse's name by arrowbox 11. Write your spouse's name exactly as you
wrote it on Form 1, by arrowbox 3.
12. Write the docket number by arrowbox 12. The docket number is the number that the
Prothonotary's Office wrote on Form 1, by arrowbox 4 at the time of filing.
Leave the rest of this document blank.
Note: This form MUST be properly served on the other party (see Divorce Procedure section).
Use Form 11 for service.