LANDLORD/TENANT COMPLAINT COMMONWEALTH OF PENNSYLVANIACOUNTY OF DEFENDANT: Mag. Dist. No: MDJ Name:Address:Telephone:PLAINTIFF:NAME and ADDRESSNAME and ADDRESSV.Docket No:Case Filed: AMOUNTDATE PAIDFILING COSTS $ POSTAGE $ SERVICE COSTS $ CONSTABLE ED. $ TOTAL$Pa.R.C.P.M.D.J. No. 206 sets forth those costs recoverable by the prevailing party. TO THE DEFENDANT: The above named plaintiff(s) asks judgment together with costs against you for the possession of real Damages for the unjust detention of the real property in the amount of$ Rent remaining due and unpaid on filing date in the amount of$ And additional rent remaining due and unpaid on hearing date$ Attorney fees in the amount of$ THE PLAINTIFF FURTHER ALLEGES THAT:$ Total: 1.The location and the address, if any, of the real property is: 2.The plaintiff is the landlord of that property. 3.The plaintiff leased or rented the property to you or to under whom you claim. 4.Notice to quit was given in accordance with law, orNo notice is required under the terms of the lease.5.The term for which the property was leased or rented is fully ended, or or, Rent reserved and due has, upon demand, remained unsatisfied.6.You retain the real property and refuse to give up to its possession. property and for:Lease is ResidentialNonresidential$I, verify that the facts set forth in this complaint are true and correct to the best of my knowledge, information and belief. This statement is made subject to the penalties of Section 4904 of the Crimes Code (18 PA. C.S. 247 4904) relating to unsworn falsification to authorities.I certify this filing complies with the UJS Case Records Public Access Policy.(Signature of Plaintiff)IF YOU HAVE A DEFENSE to this complaint you may present it at the hearing. IF YOU HAVE A CLAIM against the plaintiff arising out of the occupancy of the premises, which is in the magisterial district judge jurisdiction and which you intend to assert at the hearing, YOU MUST FILE it on the complaint form at the office BEFORE THE TIME set for the hearing. IF YOU DO NOT APPEAR AT THE HEARING, a judgment for possession and costs, and for damages and rent if claimed, may nevertheless be entered against you. A judgment against you for possession may result in your EVICTION from the premises.If you are disabled and require a reasonable accommodation to gain access to the Magisterial District Court and its services, please contact the Magisterial District Court at the above address or telephone number. We are unable to provide transportation. The plaintiff's attorney shall file an entry of appearance with the magisterial district court pursuant to Pa.R.C.P.M.D.J. 207.1 310A www.pacourts.us/language-rights FREE INTERPRETER 1 American LegalNet, Inc. www.FormsWorkFlow.com