IN THE COURT OF COMMON PLEAS OF DELAWARE COUNTY, PENNSYLVANIA CIVIL COVER SHEET AND ENTRY OF APPEARANCE Court Term & No. 1. Case Caption: ____ Jury ____ Non Jury ____ Arbitration ($0-$50,000) 2a. Plaintiff (s) (Name and address) 2b. Defendant(s) (Name and address) 3a. Related Cases? ___ Yes ___ No If yes, show Caption and Case Numbers 3b. Case Subject to Coordination Order? ___ Yes ___ No If yes, show Caption and Date of Order 4. Entry of Appearance To the Office of Judicial Support: Kindly enter my appearance on behalf of _____________________________________, (a) plaintiff in this action. Papers may be served at the address set forth below. ______________________________________ Attorney for party named above (Please print) Address: ____________________________________________ ____________________________________________ ______________________ Attorney I.D. Number ____________________________________________ Telephone: (_____)_____________Fax: (_____)______________ ______________________________________ Attorney Signature _______________________ Date Reverse side must be completed American LegalNet, Inc. www.FormsWorkflow.com Choose only the one description which best reflects the principal type of case or relief sought from the list. Case Description APPEAL Minor Court Money Judgement Landlord and Tenant Code Enforcement Personal Injury Breach of Contract Other ___________________ Local Agency Civil Service Motor Vehicle Licenses and Inspections Liquor Control Board Tax Assessment Boards Zoning Board Other ___________________ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Proceedings Commenced by Petition Appointment of Arbitrators ____ Change of Name ____ Compel Medical Examination ____ Election Matters ____ Eminent Domain ____ Leave to Issue Subpoena ____ Mental Health Proceedings ____ Other _______________________ ____ ACTIONS COMMENCED BY WRIT OF SUMMONS OR COMPLAINT Abuse of Process Action for Wrongful Death Class Action Confession of Judgement/Money Confession of Judgement/ Real Property Contract Construction Insurance/Bad Faith Negotiable Instruments Other ___________________ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Intentional Tort Assault and Battery Libel and Slander Defamation Employment/Wrongful Discharge False Imprisonment Fraud Malicious Prosecution Negligence Motor Vehicle Real Property Premises Liability Product Liability Toxic Tort Asbestos DES Implant Toxic Waste Other ___________________ Professional Malpractice Dental Legal Medical Other ___________________ Equity Real Property Stockholders Derivative Action Waste Prevention Other ___________________ Declaratory Judgement Ground Rent Mandamus Real Property Ejectment Quiet Title Mortgage Foreclosure Mechanics Lien Partition Prevent Waste Replevin Saving Action Um/Uim Quo Warranto Other _________________________ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ American LegalNet, Inc. www.FormsWorkflow.com