COMMONWEALTH  OF  PENNSYLVANIA 

COURT  OF  COMMON  PLEAS 

Judicial  District,  County  of 

NOTICE OF APPEAL 
FROM 
MAGISTERIAL DISTRICT JUDGE  JUDGMENT 

COMMON  PLEAS  No. 

NOTICE OF APPEAL 

Notice is given that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the 
Magisterial District Judge on the date and in the case referenced below. 

NAME OF APPELLANT 

MAG. DIST. NO. 

NAME OF MDJ 

ADDRESS OF APPELLANT 

CITY 

STATE 

ZIP CODE 

DATE OF JUDGMENT 

DOCKET No. 

IN THE CASE OF ( Plaintiff) 

(Defendant)` 

vs

SIGNATURE OF APPELLANT OR ATTORNEY OR AGENT 

This  block  will  be  signed  ONLY  when  this  notation  is  required  under  Pa. 
R.Civ.P.M.D.J. 1008.
This  Notice  of  Appeal,  when  received  by  the  Magisterial District  Judge , will
operate as a SUPERSEDEAS to the judgment for possession in this case.

If  appellant  was  Claimant   (see  Pa.R.Civ.P.M.D.J.  1001(6)  in action 

before a  Magisterial  District  Judge,  A  COMPLAINT  MUST  BE 
FILED within twenty (20) days after filing the NOTICE of APPEAL.

Signature of Prothonotary or Deputy

PRAECIPE  TO  ENTER  RULE  TO  FILE  COMPLAINT  AND  RULE  TO  FILE 
(This section of form to be used ONLY when appellant was DEFENDANT (see Pa.R.Civ.P.M.D.J. 1001(7) in action before Magisterial 
District Judge.  IF NOT USED, detach from copy of notice of appeal to be served upon appellee. 

PRAECIPE:  To Prothonotary 

Enter rule upon 

(Common Pleas No. 

Name of appellee(s) 

) within twenty (20) days after service of rule or suffer entry of judgment of non pros. 

appellee(s), to file a complaint in this  appeal 

__________________________________________________ 

Signature of appellant or attorney or agent 

RULE:  To 

Name of appellee(s) 

, appellee(s) 

(1) You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty (20) days after the date

of service of this rule upon you by personal service or by certified or registered mail. 

(2)

If you do not file a complaint within this time, a JUDGMENT OF NON PROS MAY BE ENTERED AGAINST YOU.

(3) The date of service of this rule if service was by mail is the date of the mailing.

Date: 

, 20 

__________________________________________ 

Signature of Prothonotary or Deputy 

YOU  MUST  INCLUDE  A  COPY  OF  THE  NOTICE  OF  JUDGMENT/TRANSCRIPT  FORM  WITH  THIS  NOTICE  OF 
APPEAL. The appellee and the magisterial district judge in whose office the judgment was rendered must be served with a 
copy of this Notice pursuant to Pa.R.Civ.P.M.D.J. 1005(A). 

AOPC 312-05 

PROOF  OF  SERVICE  OF  NOTICE  OF  APPEAL  AND  RULE  TO  FILE  COMPLAINT 

(This proof of service must be filed within 10 days after 
filing of the notice of appeal)

I hereby certify that I served the Notice of Appeal, Common Pleas No.

 ___________________________, upon the Magisterial District Judge designated therein on

 ___________________, ________ by

personal service, or

certified or registered mail, sender's receipt attached hereto,

and upon the appellee, ___________________, on ______________, ______ by

personal service, or

certified or registered mail, sender's receipt attached hereto,

I verify that the statements herein are true and correct. I understand that false statements 

herein are made subject to the penalties of Section 4904 of the Crimes Code (18 Pa.C.S. § 

4904) relating to unsworn falsification to authorities..

By: ______________________________ 

 Name

    Signature

________________________________ 

Date: ___________________________ 

AOPC 312A - 05