CARBON COUNTY COURT OF COMMON PLEAS ORPHANS’ COURT DIVISION PETITION/PLEADING COVER SHEET FOR COURT USE ONLY ASSIGNED TO JUDGE: ___________________________ Estate of: ____________________________________________________ DATE:_______________________ Type of Estate: ______________________________________ Do not telephone Judge for status. Do not send Judge courtesy copies. O.C. No. __________________ of _______________________ Name of Filing Party: ____________________________________________________ (Check one) ____ Moving Party Type of Petition/Pleading or Document: __________________________________________ ____ Responding Party C. Has another petition been decided in this case? ___ Yes___ No Is another petition pending? ___ Yes ___ No __________________________________________ If yes, identify the judge, and/or the status of the petition(s). A. Is Notice Required: D. OTHER PARTIES (Name, address and telephone number of all counsel of record and unrepresented parties. If needed, use separate sheet.) ___ No ___ No. All required waivers are attached. ___ Yes. Copy of notice and certification attached. Date of Notice: __________________________ Response Date: __________________________ B. If Citation is Requested: 1. Was Citation Against Instant Respondent previously issued? ___ Yes ___ No 2. If yes, was it served? ___ Yes. No additional citation is necessary. Notice is required. ___ No. Explain why it was not served. Attach a stamped addressed envelope for each attorney of Record and unrepresented party. By filing this document and signing below, the moving or responding party certifies that no notice was required, or that this petition/response, along with all documents filed, were served upon all counsel and unrepresented parties, in accordance with Carbon _____________. Further, the moving or responding party verifies (subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities) that the answers made herein are true and correct and understands that sanctions may also be imposed for inaccurate or incomplete answers. ________________________________________________ ________________________________________________ (Attorney Signature/Unrepresented Party) (Print Name) (Attorney I.D. No.) This Petition or Pleading will be forwarded to the Court after the Response Date, or immediately if no notice or response is required. 2002 © American LegalNet, Inc.