Fill - Free fillable IN THE COURT OF COMMON PLEAS OF ALLEGHENY (Fifth Judicial District of Pennsylvania) PDF form

IN THE COURT OF COMMON PLEAS OF ALLEGHENY COUNTY,

PENNSYLVANIA

CIVIL DIVISION

Case No.

________________________

_______________________________

________________________

________________________ Type of Pleading:

Appellant(s)

Statutory Appeal

vs.

________________________ Filed on Behalf of Appellant:

________________________

______________________________

________________________

Appellee(s)

ADDRESS, TELEPHONE, AND EMAIL

OF:

Appellant, filing Pro Se

______________________________

Phone #: _______________________

E-Mail: ________________________

IN THE COURT OF COMMON PLEAS OF ALLEGHENY COUNTY,

PENNSYLVANIA

CIVIL DIVISION

________________________

Appellant(s) Case No.

vs.

_____________________

________________________

Appellee(s)

Notice of Appeal

And Now, to-wit, this _

______ day of

_____________________________, 2020, notice

is hereby given that

takes this appeal pursuant to Local Agency Law, Subchapter B of Chapter 7, 2 Pa.C.S.A. § 751

et seq, 1978, April 28, P.L. 202, No. 53, Section 10(12), effective June 27, 1978, from the

decision of the Housing Authority denying Appellant’s grievance.

______________________________________________________________________________

Respectfully Submitted,

______________________________

IN THE COURT OF COMMON PLEAS OF ALLEGHENY COUNTY, PENNSYLVANIA

CIVIL DIVISION

Appellant(s)

vs.

Appellee(s)

VERIFICATION

certify that the facts

contained in the foregoing motion are true and correct to the best of my

knowledge, information, and belief. I understand that false statements herein

are subject to the Penalties of 18 Pa.C.S. § 4904 related to unsworn

falsification to authorities.

Date Signature

CERTIFICATE OF SERVICE

The undersigned certifies that a true and correct copy of the within __________________

______________________________ was served this ____ day of ________________________,

20___, by U.S. First Class Mail, postage pre-paid, upon the following:

______________________________

_________________________ ______________________________

Date

Name

Statutory Appeal

Must include phone number and, if

possible, e-mail address for served party

If the opposing side is represented by an

attorney, then serve the attorney

IN THE COURT OF COMMON PLEAS OF ALLEGHENY COUNTY, PENNSYLVANIA

CIVIL DIVISION

_____________________________

Plaintiff(s)

CASE NO. _______________________

Vs.

_____________________________

Defendant(s)

Order of Court

AND NOW, this ___________ day of ___________________________, 20____, it is

ORDERED that: ________________________________________________________________

______________________________________________________________________________

BY THE COURT,

__________________________, J

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