IN THE COURT OF COMMON PLEAS OF MONTGOMERY COUNTY, PENNSYLVANIA CIVIL ACTION - LAW : NO. VS. : : PRAECIPE FOR ENTRY OF JUDGMENT OF NON PROS PURSUANT TO RULE 1042.7 TO THE PROTHONOTARY: Enter judgment of non pros against _________________________________________ Plaintiff in the professional liability claim against _______________________________________ in the Defendant above captioned matter. I, the undersigned, certify that the Plaintiffs named above have asserted a professional liability claim against the Defendant named above who is a licensed professional, that no certificate of merit has been filed within the time required by Pa. R.C.P. 1042.3 and that there is no motion to extend the time for filing the certificate pending before the court. BY:______________________________________ Defendant or Attorney for Defendant DATE: PRIF0045 R 10/11 American LegalNet, Inc. www.FormsWorkFlow.com