IN THE COURT OF COMMON PLEAS OF LEHIGH COUNTY, PENNSYLVANIA CIVIL DIVISION : : Plaintiff vs. : : File No. : : Defendant : Notice of Appeal from Award of Board of Arbitrators To The Clerk of Judicial Records - Civil Division: Notice is given that _________________________ appeals from the award of the board of arbitrators entered in this case on ___________________________________________________. A jury trial is demanded is waived.) I hereby certify that: 1. the compensation of the arbitrators has been paid, OR 2. application has been made for permission to proceed in forma pauperis. (Strike out the inapplicable clause.) Appellant or attorney for appellant Print Name of appellant or attorney . (Check box if a jury trial is demanded: Otherwise jury trial (Rev 2/12) American LegalNet, Inc. www.FormsWorkFlow.com Pursuant to Rule 1308(b), the appellant shall provide the Clerk required notices for mailing and properly stamped & addressed envelopes for opposing counsel. CHECK # in the amt. of $ by for Arbitrators Compensation received on . (Rev 2/12) American LegalNet, Inc. www.FormsWorkFlow.com