IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

CIVIL DIVISION

:
:
Plaintiff	:
vs.	:	File No.
:	IN DIVORCE
:
Defendant	:

PRAECIPE TO TRANSMIT RECORD

To The Clerk of Judicial Records – Civil Division:

Transmit the record, together with the following information, to the court for entry of a divorce decree:

1.	Ground for divorce: irretrievable breakdown under ( 3301(c) 3301(d) of the Divorce Code.

Date and Manner of Service of the Complaint and Notice to Defend and Claim Rights:

Date of Service:

Manner of Service:

Certified mail, return receipt requested, restricted delivery

Other:

3.	Execution of required affidavits. Complete either (a) or (b):

(a)	( 3301(c) of the Divorce Code:

Date of execution of the affidavits of consent:

Date Affidavit of Consent was signed by plaintiff:

Date Affidavit of Consent was signed by defendant:

(b) ( 3301(d) of the Divorce Code:

(1) Date of execution of the Affidavit Under §3301(d):

(2) Date of filing of the Affidavit Under §3301(d):

(3) Date of service of the Affidavit Under §3301(d):

4. Related claims pending: None

5. Waiver of Notice/Notice of Intention. Complete either (a) or (b).

(a) ( 3301(c) of the Divorce Code:

(1) Date plaintiff’s Waiver of Notice was filed with the Civil Division:

(2) Date defendant’s Waiver of Notice was filed with the Civil Division:

(b) ( 3301(d) of the Divorce Code:

Notice of Intention to Request Divorce Decree and Blank copy of Counter Affidavit, a copy of which is attached:

Date of Service:

Manner of service:

First Class mail

Other

(Plaintiff) or (Defendant)

Print/Type Name

(Rev. 2/16 Form 8)

IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA

Rachel A Wotring

2016-02-04

Gateway 2000