TENANT: 
LOKATÈ: 
 

VS. / KONT 

NAME and ADDRESS 
NON ak ADRÈS 
 
 

Common Pleas Docket No. 
Nimewo Lis Dosye Tribinal Defans an Komen. 

 

 

 

     

     

 

 

 

COMMONWEALTH OF PENNSYLVANIA 
KOMINOTE PENNSYLVANIA 

COURT OF COMMON PLEAS 
TRIBINAL DEFANS AN KOMEN 

LANDLORD: 
MÈT KAY LA: 

NAME and ADDRESS 
NON ak ADRÈS 
 
 

SECTION 8 TENANT’S SUPERSEDEAS 
AFFIDAVIT FILED PURSUANT TO 
Pa.R.C.P.M.D.J. No. 1008C(2) 

AFIDAVID SUPERSEDEAS LOKATÈ SEKSYON 
8 KI DEPOZE SELON Pa.R.C.P.M.D.J. NIMEWO 
1008C(2) 

I, _________________________ 

__________________________________ (print 

Mwen, _________________________ 
__________________________________ (ekri 

name and address here), have filed a notice of 
appeal from a magisterial district court judgment 

non ak adrès ak lèt detache la a), te depoze yon 
avi pou apèl jiridik nan yon jijman tribinal distri 

awarding my landlord possession of real property 
that I occupy, and I do not have the financial ability 

majistral ki bay mèt kay mwen an posesyon byen 
imobilye mwen okipe a, epi mwen pa gen kapasite 

to pay the lesser of three times my monthly rent or 
the actual rent in arrears. My total household 

finansyè pou m peye montan ki pi piti nan twa fwa 
kòb lwaye chak mwa mwen an oswa kòb lwaye 

income does not exceed the income limits set forth 
in the supplemental instructions for obtaining a 
stay pending appeal 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. 

reyèl la an reta. Revni total moun nan kay mwen 
pa depase limit revni ki prezante nan enstriksyon 

siplemantè yo pou m jwenn yon sispansyon 
annatandan yon apèl jiridik epi mwen te ranpli yon 
afidavid in forma pauperis (IFP) pou mwen verifye 
sa. Mwen te/pa t (bife sa ki pa aplike a) peye kòb 

lwaye mwa sa a. 

The total amount of monthly rent that I 

Montan total lwaye chak mwa mwen peye mèt 

personally pay to the landlord is $ __________. I 
hereby certify that I am a participant in the Section 
8 program and I am not subject to a final (i.e., non-
appealable) decision of a court or government 

agency that terminates my right to receive Section 
8 assistance based on my failure to comply with 
program rules. 

kay la pèsonèlman se $ __________. Mwen 
sètifye nan dokiman sa a mwen se yon patisipan 

nan pwogram Seksyon 8 la epi mwen pa gen yon 
desizyon final (sa vle di, san apèl jiridik) yon tribinal 
oswa ajans gouvènman ki mete fen nan dwa m 
genyen pou m benefisye asistans Seksyon 8 ki 
baze sou lefètke mwen pa respekte règ pwogram 

lan. 

ounty Of 

Konte 

    C

     

 

 

 

  M

sèman. 

 verify that the statements made in this affidavit 

wen verifye deklarasyon ki fèt nan afidavid sa 

are true and correct to the best of my knowledge, 

a se verite epi yo kòrèk selon pi bon konesans, 

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

enfòmasyon ak kwayans mwen. Mwen konprann fo 
deklarasyon mwen fè nan dokiman ap genyen 

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

penalite Seksyon 18 Pa.C.S. § 4904, ki gen rapò 
ak bay otorite yo fo deklarasyon ki pa fèt sou 

  I

_________________ 

Date / Dat 

 

 

___________________________________________ 
SIGNATURE OF TENANT / SIYATI LOKATÈ A 

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        A

 

OPC 312-08 (A)