11-16-04 FIRST JUDICIAL DISTRICT OF PENNSYLVANIA COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY Commonwealth of Pennsylvania vs. : TRIAL DIVISION - CRIMINAL : : : Motion Control _________________________________ Appellant No. ____________________________ PETITION TO APPEAL NUNC PRO TUNC 1) Appellant, ______________________________________, who resides at the following address: __________________________________________________________________________________, City: ________________________; State: __________; ZIP CODE: __________ hereby requests the Court’s permission to file an appeal after the 30-day appeal period has expired (Appeal “Nunc Pro Tunc”) of the following citations which were adjudicated by the Philadelphia Traffic Court as follows: Citation No. Issue Date Badge No. Offense Disposition Date Disposition Date of Order Appealed 2) Appellant understands that Appeals from Traffic Court decisions must be filed within thirty days of the date of guilty plea, conviction or issuance of a final order, and that Petitions for permission to file an Appeal after the 30-day appeal period has expired (Appeal “Nunc Pro Tunc”) can only be granted if Appellant alleges and proves that: (1) the delay in filing the appeal was caused by extraordinary circumstances involving fraud or wrongful or negligent act of a court official; and (2) Appellant acted promptly in filing the Appeal after learning of the existence of the fraud or wrongful or negligent act of a court official. In support of the request for permission to Appeal Nunc Pro Tunc, Appellant alleges the following fraud, wrongful or negligent act committed by a court official as well as when this information was discovered (Attach additional pages if needed): I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904, relating to unsworn falsification to authorities. Date:_____________________ ______________________________ APPELLANT’S SIGNATURE American LegalNet, Inc. www.USCourtForms.com 11-16-04 Commonwealth of Pennsylvania vs. ___________________________________ Motion Control No. ___________________________________ HEARING NOTICE PETITION TO APPEAL NUNC PRO TUNC A hearing in the within Petition to Appeal Nunc Pro Tunc is scheduled for ___________________________________________________________, at __________AM/PM, in Courtroom _________, Criminal Justice Center, 1301 Filbert Street, Philadelphia, PA. 19102. Pennsylvania Rule of Criminal Procedure 575 does not require that a written Answer be filed to this Petition. An oral response may be offered at the hearing. FAILURE TO APPEAR ON THE SCHEDULED HEARING DATE WILL RESULT IN THE DISMISSAL OF THIS PETITION. FOR THE COURT: Date: ______________ ____________________________ FOR COURT USE ONLY ORDER AND NOW, this _________day of ______________________, 20____, upon a review of the Petition To Appeal Nunc Pro Tunc, and after a hearing thereon, it is hereby ORDERED that the said Petition is DISMISSED, Defendant having failed to appear for the hearing. This is a FINAL ORDER. The hearing will not be rescheduled. DENIED. GRANTED as to the following traffic citation(s) ONLY and Defendant is authorized to file a Notice of Appeal From Summary Conviction (Traffic) - Nunc Pro Tunc in connection with those citations at the Traffic Court, 800 Spring Garden Street, Philadelphia, PA.: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ BY THE COURT: _____________________________ J. American LegalNet, Inc. www.USCourtForms.com