COMMONWEALTH OF PENNSYLVANIA 

COURT OF COMMON PLEAS 

County Of          

LANDLORD:

NAME and ADDRESS

TENANT: 

VS. 

NAME and ADDRESS 

Common Pleas Docket No. 

TENANT’S SUPERSEDEAS AFFIDAVIT (NON-SECTION 8)  
FILED PURSUANT TO Pa.R.Civ.P.M.D.J. 1013C(2) 

I,                                                                                                       (print name and address here), 

have filed a praecipe for a writ of certiorari to review a magisterial district court judgment awarding to my 

landlord possession of real property that I occupy, and I do not have the financial ability to pay the lesser of 

three times my monthly rent or the judgment for rent awarded by the magisterial district court. My total 

household income does not exceed the income limits set forth in the instructions for obtaining a stay 

pending issuance of a writ of certiorari and I have completed an in forma pauperis (IFP) affidavit to verify 

this. I have/have not (cross out the one that does not apply) paid the rent this month. 

I verify that the statements made in this affidavit are true and correct to the best of my knowledge, 

information, and belief. I understand that false statements herein are made subject to the penalties of          

18 Pa.C.S. § 4904, relating to unsworn falsification to authorities. 

__________ 
Date 

__________________________ 
SIGNATURE OF TENANT 

AOPC 312-08 (D) 



Microsoft Word - AOPC 312-08 _D_.doc

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• Sourced from www.pacourts.us (2023-03)
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