IN THE COURT OF COMMON PLEAS OF ALLEGHENY COUNTY, PENNSYLVANIA CIVIL DIVISION PRAECIPE FOR DEFAULT JUDGMENT Plaintiff Case Number - Defendant - Vs ______________________________________________________________________________________________ To : Director, Department of Court Records, Civil/Family Division Enter judgment against above named defendent in default of answer in the sum of $_________________ liquidated as follows : Amount claimed in complaint ................................................................................... $_________________ Interest from ____________________________________________________ on $_________________ Other fees 1(ex.: Attorney/Late Charges)_________________________________ $_________________ Other fees 2________________________________________________________ $_________________ Other fees 3________________________________________________________ $_________________ Total ......................................................................................................................... $_________________ Attorney for Plaintiff Signature : ___________________________________ Name : ___________________________________ Date : _________________________ American LegalNet, Inc. www.FormsWorkflow.com [jdflt]