CI - - 1 IN THE COURT OF COMMON PLEAS OF LANCASTER COUNTY, PENNSYLVANIA CIVIL ACTION - LAW CI - - PLAINTIFF(S) CI - XX - XXXXX VS. DEFENDANT(S) PRAECIPE FOR REFERENCE (REQUEST FOR ARBITRATION) T O T HE P ROTHONOTARY OF S AID C OURT : Assign the above case to a Board of Arbitrators for a hearing. The amount in controversy is $50,000 or less and the case is at issue for arbitration. This case is to be tried by and notices sent to the following attorneys: (List names, addresses, telephone numbers, facsimile numbers and email addresses) There is a Companion Case, Docket: , to be tried with this action. Estimated Time for Hearing . Date Attorney for American LegalNet, Inc. www.FormsWorkFlow.com CI - - 2 Praecipe for Reference (Request for Arbitration) filing requirements. The following must be included when submitting this filing to the Lancaster County Prothonotary Office. 1) 1 original and 3 copies 2) Self - Addressed Stamped Envelopes (SASE) for all attorneys and unrepresented parties 3) Filing fee $ 36.00 American LegalNet, Inc. www.FormsWorkFlow.com