IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

CIVIL DIVISION

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Plaintiff	:
vs.	:	File No.
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Defendant	:

Notice of Appeal from Award of Board of Arbitrators

To Clerk of Judicial Records – Civil Division:

Notice is given that appeals from the award of the board of arbitrators entered in this case on .

A jury trial is demanded . (Check box if a jury trial is demanded: Otherwise jury trial is waived.)

I hereby certify that:

the compensation of the arbitrators has been paid, OR

application has been made for permission to proceed in forma pauperis.

(Strike out the inapplicable clause.)

Appellant or attorney for appellant
Print Name of appellant or attorney

Pursuant to Rule 1308(b), the appellant shall provide the Clerk required notices for mailing and properly stamped & addressed envelopes for opposing counsel.

CHECK #	in the amt. of $	for Arbitrators Compensation received on

by	.

(Rev 2/12)

IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

Rachel A Wotring

2012-02-06