IN THE COURT OF COMMON PLEAS OF ___________________________ COUNTY, PENNSYLVANIA CIVIL DIVISION : : : : : : : : : File No. ________________________________ PRAECIPE FOR JUDGMENT OF NON PROS TO THE PROTHONOTARY/CLERK OF SAID COURT: Enter Judgment of Non Pros against the above-named Plaintiff(s): ____________________________ ________________________________________________________________________________________ Pursuant to Pa. R.C.P. No. 237.1, I certify that written notice of the intention to file this praecipe was mailed or delivered to the party against whom judgment is to be entered and to his or her Attorney of Record, if any, after the default occurred and at least ten (10) days prior to the date of the filing of this praecipe and a copy of the notice is attached. I verify that I have researched the records in this matter, and a complaint has not been filed within twenty (20) days following the service of the Rule in this matter. I further verify that the statements made in this Praecipe are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. § 4904 relating to Unsworn Falsification to Authorities. DATE: ______________________ Signature: _________________________________ Print Name: ________________________________ Attorney for: ________________________________ Address: ___________________________________ ____________________________________ Telephone: _________________________________ Supreme Court ID No.: ________________________ M-3F-1 (Rev. 4/00) American LegalNet, Inc. www.FormsWorkflow.com