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PA Bulletin, Doc. No. 18-137

THE COURTS

Title 255—LOCAL COURT RULES

DAUPHIN COUNTY

Promulgation of Local Rules; No. 1793 S 1989

[48 Pa.B. 598]
[Saturday, January 27, 2018]

Order

And Now, this 8th day of January 2018, Dauphin County Local Rules 1911.11.1, 1915.3, 1915.3.1, 1915.7, 1915.15(c), 1920.1, 1920.74(b), 1930 and 1930.8 are amended as follows:

Rule 1910.11.1.

 The Educational [Parenting] Seminar Attendance Order shall be substantially in the following form:

: IN THE COURT OF COMMON PLEAS
: DAUPHIN COUNTY, PENNSYLVANIA
Plaintiff :
: PACSES CASE NUMBER
:
Defendant : DOCKET NO.

EDUCATIONAL [PARENTING] SEMINAR ATTENDANCE ORDER

 All parties are ORDERED to attend a four hour educational [parenting] seminar (Seminar for Families in Change and Conflict) and file [the] your Certificate of Attendance [you will receive at the Seminar] at the Domestic Relations Office prior to your hearing before the Court.

 The Plaintiff shall attend on ______ at ______ __ M and the Defendant shall attend on ______ at ______ __ M. Any requests for rescheduling must be directed to the provider of the Seminar [and you will be required to]. You should attend the next available Seminar. (See attached information sheet for additional information).

 You MUST attend and complete the Seminar prior to your Hearing before the Court.

FAILURE TO ATTEND AND COMPLETE [APPEAR AT] THE SEMINAR [AS SCHEDULED OR FAILURE TO REGISTER AND COMPLETE THE PROGRAM] WILL BE BROUGHT TO THE ATTENTION OF THE COURT AND MAY RESULT IN THE FINDING OF CONTEMPT OF COURT PUNISHABLE BY FINE AND OTHER APPROPRIATE SANCTIONS.

BY THE COURT:

DATE: ______  _________________

Rule 1915.3. Custody Actions.

 (a) Commencement of Custody Actions

 1. A custody action shall be commenced by the filing of an original and one copy of either a Custody Complaint or a Divorce Complaint or Counterclaim that contains a custody count with the Prothonotary in accordance with Pa.R.C.P. 1915.3.

 2. In addition to the filing fees assessed for the filing of complaints, an additional administrative fee in the amount of $150.00 shall be paid to the Prothonotary simultaneously with the filing of the Custody action.

 (b) A Custody Action shall include the following attachments:

 1. A Seminar Attendance and Custody Conference Scheduling Order in accordance with Local Rule 1915.15(c).

 2. Prior Court Involvement Statement in accordance with Local Rule 1931. This form is available at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 3. A Criminal or Abuse History Verification in accordance with Pa.R.C.P. 1915.3-2. This form is available at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 4. Self-Represented Party Entry of Appearance, if not represented by legal counsel, in accordance with Local Rule 1930.8. This form is available at www.dauphin county.org/government/Court-Departments/Self-Help-Center.

 (c) The Prothonotary shall promptly forward the original Custody [action] Complaint with the attachments listed above to the Court Administrator's Office for assignment to a Custody Conference Officer and scheduling of the Seminar.

 (d) The Court Administrator's Office will contact a Custody Conference Officer to establish the date, time and location of the Custody Conference which will generally be scheduled after the dates for the parties' attendance at the mandatory four hour educational [parenting] seminar (Seminar for Families in Change and Conflict) in accordance with Local Rule 1930.

 (e) The Court Administrator's Office will insert the assigned dates, times and location on the Seminar Attendance and Custody Conference Scheduling Order.

 (f) The Court Administrator's Office shall file the Order with the Prothonotary and promptly notify the Plaintiff(s) or their legal counsel, if represented, that the Custody action, attachments, Seminar Attendance and Custody Conference Scheduling Order are ready to pick up for service on the other parties in accordance with the applicable rules of civil procedure.

 (g) Plaintiff(s) or their legal counsel, if represented, shall promptly file a Certificate of Service with the Prothonotary verifying that they have served the Complaint, attachments and Order on all parties before the date of the scheduled Seminars and Custody Conference.

 (h) If the parties do not reach an agreement at the Custody Conference (see Local Rule 1915.4-2), the case will be assigned to a Family Court Judge.

 (i) As a general rule, if a Judge has handled a contested family law case for that family, the matter will be assigned to that Judge.

Rule 1915.3.1. Petitions for Modification of a Custody Order.

 (a) An original and one copy of a Petition for Modification of a Custody Order shall be filed with the Prothonotary together with the administrative fee of $150.00.

 (b) A Petition for Modification of a Custody Order shall include the following attachments:

 1. A Seminar Attendance and Custody Conference Scheduling Order in accordance with Local Rule 1915.15(c).

 2. Prior Court Involvement Statement in accordance with Local Rule 1931. This form is available at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 3. A Criminal or Abuse History Verification in accordance with Pa.R.C.P. 1915.3-2. This form is available at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 4. Self-Represented Party Entry of Appearance, if not represented by legal counsel, in accordance with Local Rule 1930.8. This form is available at www.dauphin county.org/government/Court-Departments/Self-Help-Center.

 5. A copy of the most recent Custody Order[, Agreement or Parenting Plan].

 (c) The Prothonotary shall promptly forward the original Petition for Modification of a Custody Order with the attachments listed above to the Court Administrator's Office for assignment to a Custody Conference Officer and scheduling of the Seminar.

 (d) The Court Administrator's Office shall contact a Custody Conference Officer to establish the date, time and location of the Custody Conference which will generally be scheduled after the dates for the parties' attendance at the mandatory four hour educational [parenting] seminar (Seminar for Families in Change and Conflict) in accordance with Local Rule 1930. Attendance at the Seminar is not required if the parties have attended the Seminar within the last twelve (12) months unless ordered by the Court.

 (e) The Court Administrator's Office will insert the dates, times and location on the Seminar Attendance and Custody Conference Scheduling Order.

 (f) The Court Administrator's Office shall file the Order with the Prothonotary and promptly notify the Petitioner(s) or their legal counsel, if represented, that the Petition for Modification, attachments and Seminar Attendance and Custody Conference Scheduling Order are ready for service on the other parties in accordance with the applicable rules of civil procedure.

 (g) The Petitioner or their legal counsel, if represented, shall promptly thereafter file a Certificate of Service verifying that they have served the Petition, attachments and Order on all parties with the Prothonotary before the date of the scheduled Seminars and Custody Conference.

 (h) If the parties do not reach an agreement at the Custody Conference (see Local Rule 1915.4-2), the Conference Officer may recommend an Interim Order and the case will be assigned to a Family Court Judge.

 (i) As a general rule, if a Family Court Judge has handled a contested family law case for that family, the matter will be assigned to that Judge.

1915.7. Agreements [and Consent Orders].

 (a) Agreements [and consent orders] filed contemporaneously with the custody complaint:

 1. When [a custody agreement has been reached] the parties reach an agreement prior to the filing of the custody complaint, either party shall file [with the Prothonotary the original signed custody agreement simultaneously with the original and one copy of the custody complaint] the original and one copy of the custody complaint with the Prothonotary and bring the original signed custody agreement to the Court Administrator's Office for assignment to a Family Court Judge. The agreement shall not be filed with the Prothonotary at the same time that the custody complaint is filed. The agreement will be filed with the Prothonotary as an attachment to the Court Order.

 2. The [custody] agreement shall be signed by all parties and the signatures shall be witnessed or notarized unless the agreement is reached before the Custody Conference Officer or the Court.

 3. The [custody] agreement shall contain a proposed order of court with a distribution legend.

 4. An administrative fee of $150.00 shall be paid to the Prothonotary in accordance with Rule 1915.3(a) or (b).

 5. [The Prothonotary shall forward the original custody complaint and the signed and witnessed custody agreement to the Court Administrator's Office for review and assignment to the judge assigned to oversee custody matters.

6.]Agreements shall contain a paragraph regarding the parties' responsibilities if one party seeks permission to relocate when such relocation will significantly impair the ability of a non-relocating party to exercise his or her custodial rights. The agreement shall contain the language and exhibit used by the Court posted at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 (b) Agreements [and consent orders] to modify existing custody orders:

 1. When the parties agree to modify an existing custody order, the original agreement [and consent order shall be filed with the Prothonotary] and proposed order shall be taken to the Court Administrator's Office for assignment to a Family Court Judge. The agreement shall not be filed with the Prothonotary but will be filed as an attachment to the Court Order. A petition for modification of a custody order should not be filed. There shall be no administrative fee paid to the Prothonotary for the modification of an existing custody order when no petition for modification of a custody order has been filed.

 2. The [custody] agreement shall be signed by all parties and the signatures shall be witnessed or notarized.

 3. The [custody] agreement shall contain a proposed order of court with a distribution legend.

 4. [The Prothonotary shall forward the original signed and witnessed custody agreement to the Court Administrator's Office for review and assignment to the judge assigned to oversee custody matters.

5.]Agreements shall contain a paragraph regarding the parties' responsibilities if one party seeks permission to relocate when such relocation will significantly impair the ability of a non-relocating party to exercise his or her custodial rights. The agreement shall contain the language and exhibit used by the Court posted at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 (c) Agreements reached after the complaint or petition for modification of a custody order is assigned to a Custody Conference Officer:

 1. If at any time prior to the Custody Conference the parties are able to agree upon custody, the parties shall [file with the Prothonotary the proposed custody agreement] take the original signed agreement to the Court Administrator's Office for assignment to a Family Court Judge. The custody agreement shall not be filed with the Prothonotary but will be filed as an attachment to the Court Order. The [custody] agreement shall be signed by all parties and the signatures shall be witnessed or notarized. The [custody] agreement shall contain a proposed order of court with a distribution legend.

 2. [The Prothonotary shall forward the original signed and witnessed custody agreement to the Court Administrator's Office for review and assignment to the judge assigned to oversee custody matters.

3.]Agreements shall contain a paragraph regarding the parties' responsibilities if one party seeks permission to relocate when such relocation will significantly impair the ability of a non-relocating party to exercise his or her custodial rights. The agreement shall contain the language and exhibit used by the Court posted at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 (d) Agreements reached after a custody matter has been assigned to a judge:

 1. If at any time prior to a conference or hearing before the assigned judge an agreement is reached regarding custody [or visitation, the parties shall file with the Prothonotary the proposed agreement and consent order with a distribution legend], the parties shall take the original signed agreement to the Court Administrator's Office for assignment to the assigned Family Court Judge. The agreement shall not be filed with the Prothonotary but will be filed as an attachment to the Court order. The agreement shall be signed by all parties and the signatures shall be witnessed or notarized. [The Prothonotary shall forward the original signed and witnessed custody agreement to the Court Administrator's Office for delivery to the assigned judge.] Upon presentation of the agreement and consent order, the Court may, in its discretion, enter an order without taking testimony.

 2. The parties or children need not be present at a scheduled pretrial conference or hearing before a judge when an agreement has been reached prior to the conference or hearing unless the Court so directs.

 3. Agreements shall contain a paragraph regarding the parties' responsibilities if one party seeks permission to relocate when such relocation will significantly impair the ability of a non-relocating party to exercise his or her custodial rights. The agreement shall contain the language and exhibit used by the Court posted at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

Rule 1915.15(c). Educational [Parenting] Seminar Attendance and Custody Conference Scheduling Order—Custody Complaint, Custody Count in Divorce Complaint or Petition for Modification or Petition for Contempt.

 In addition to the information required by Pa.R.C.P. 1915.15(a) or 1915.15(b), each Custody Complaint, Petition for Modification, Petition for Contempt, or custody count in a Divorce action relating to child custody shall include an Educational [Parenting] Seminar Attendance and Custody Conference Scheduling Order in substantially the following form:

: IN THE COURT OF COMMON PLEAS
: DAUPHIN COUNTY, PENNSYLVANIA
Plaintiff :
: CIVIL ACTION
: CUSTODY
:
Defendant : NO.

EDUCATIONAL [PARENTING] SEMINAR AND CUSTODY CONFERENCE SCHEDULING ORDER

 AND NOW, upon consideration of the attached Complaint, Petition for Modification or Petition for Contempt of a Custody Order, it is hereby ordered that the parties and their respective counsel appear before Custody Conference Officer ______  on ______ , 20 __ at ____ __ M, Dauphin County Courthouse, 3rd Floor, 101 Market Street, Suite 300, Harrisburg, Pennsylvania for a Custody Conference.

 At such Conference, an effort will be made to conciliate and resolve the issues in dispute, or if this cannot be accomplished, to define and narrow the issues to be heard by the Court and to recommend an interim order pending pretrial/trial. Failure to appear may also result in an interim order being entered.

 Children should not attend the conference unless requested by the Custody Conference Officer.

 All parties are ORDERED to attend a four hour educational [parenting seminar and file] seminar (Seminar for Families in Change and Conflict). File with the Prothonotary and bring with you to the Custody Conference your Seminar Certificate of Attendance you will receive at the Seminar. The Plaintiff is scheduled to attend on ______ at ____ __ M and the Defendant is scheduled to attend on ______ at ____ __ M. Any requests for rescheduling must be directed to the provider of the Seminar and you will be required to attend the next available Seminar. (See attached information sheet regarding the Seminar).

FAILURE TO [APPEAR AT] ATTEND AND COMPLETE THE SEMINAR [AS SCHEDULED OR FAILURE TO REGISTER AND COMPLETE THE PROGRAM] WILL BE BROUGHT TO THE ATTENTION OF THE COURT AND MAY RESULT IN THE FINDING OF CONTEMPT OF COURT PUNISHABLE BY FINE AND OTHER APPROPRIATE SANCTIONS.

IF YOU FAIL TO APPEAR AT THE CUSTODY CONFERENCE [AS PROVIDED BY THIS ORDER,] WITHOUT PROPER CAUSE SHOWN, [AND THE CUSTODY CONFERENCE OFFICER IS SATISFIED THAT PROPER NOTICE OF THE ORDER SCHEDULING THE CONFERENCE HAS BEEN SERVED ON OR PROVIDED TO THAT PARTY,] THE CUSTODY CONFERENCE OFFICER SHALL REFER THE MATTER TO THE COURT FOR A CONTEMPT HEARING WHICH CAN RESULT IN AN INTERIM CUSTODY ORDER, THE IMPOSITION OF SANCTIONS INCLUDING FINES, ATTORNEY FEES AND COSTS.

 You must complete and file with the Prothonotary a Criminal or Abuse History Verification regarding you and anyone living in your household on or before ______ . The Criminal or Abuse History Verification is attached [This form] and is also available at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 You must mail a copy of your Criminal or Abuse History Verification to all other parties by ______ .

 No party may [make a] change [in] the child(ren)'s residence [of any child] which significantly impairs the ability of the other party to exercise custodial rights without first complying with all of the applicable provisions of 23 Pa.C.S. § 5337 and Pa.R.C.P. No. 1915.17 regarding relocation.

 If any party to this custody action is incarcerated at any stage of the proceedings, the Custody Conference Officer or [assigned] Judge will make reasonable efforts to arrange for the incarcerated party to participate by telephone or video conference. If you, as an incarcerated party, do not think such arrangements have been made, please contact the Court Administrator's office at (717) 780-6624 or by mail at 3rd floor, Dauphin County Courthouse, 101 Market Street, Harrisburg, PA 17101.

 If any party needs an interpreter at either the custody conference or trial, please contact the Court Administrator's office at (717) 780-6640 or email interpreterrequest@dauphinc.org as soon as possible. It takes a minimum of five days to schedule an interpreter and failure to make a timely request could delay the proceedings.

FOR THE COURT:

DATE: ______  By _________________
 Custody Conference Officer

YOU SHOULD TAKE THIS [PAPER] ORDER TO YOUR LAWYER AT ONCE.

 IF YOU DO NOT HAVE A LAWYER AND WANT A LAWYER TO REPRESENT YOU, IMMEDIATELY CONTACT MIDPENN LEGAL SERVICES AT (717) 232-0581 TO OBTAIN LEGAL REPRESENTATION OR REFERRAL TO THE DAUPHIN COUNTY BAR ASSOCIATION LAWYER REFERRAL.

AMERICANS WITH DISABILITIES ACT OF 1990

 The Court of Common Pleas of Dauphin County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact the Court Administrator's Office at [(717) 780-6630] (717) 780-6608. All arrangements must be made at least 72 hours prior to any hearing or conference.

1920.1. Form of Divorce or Annulment Complaint.

 (1) In addition to the information required by Pa.R.C.P. 1920.12, each Divorce or Annulment Complaint shall contain one of the following averments:

 A. Plaintiff avers that there are no children of the parties under the age of 18.

 B. Plaintiff avers that there are children of the parties under the age of 18 [and their names and ages are as follows:].

 (2) A Divorce or Annulment Complaint or Counterclaim which includes a count for custody shall contain the attachments set forth in Local Rule 1915.3 and follow all other Custody action procedures.

 (3) A Divorce or Annulment Complaint which does not include a count for custody, where the parties are parents of children under the age of eighteen (18), shall include the [following] Educational [Parenting] Seminar Scheduling Order.

: IN THE COURT OF COMMON PLEAS
: DAUPHIN COUNTY, PENNSYLVANIA
Plaintiff :
: CIVIL ACTION
:
Defendant : NO.

EDUCATIONAL [PARENTING] SEMINAR SCHEDULING ORDER

 All parties are ORDERED to attend a four hour educational [parenting] seminar (Seminar for Families in Change and Conflict) and file your Certificate of Attendance you receive at the Seminar with the Prothonotary. The Plaintiff is scheduled to attend on ______ at __ M and the Defendant is scheduled to attend on ______ at __ M. Any requests for rescheduling must be directed to the provider of the Seminar and you [will be required to] should attend the next available Seminar. (See attached information sheet for additional information).

 FAILURE TO [APPEAR AT] ATTEND AND COMPLETE THE SEMINAR [AS SCHEDULED OR FAILURE TO REGISTER AND COMPLETE THE PROGRAM] WILL BE BROUGHT TO THE ATTENTION OF THE COURT AND MAY RESULT IN A FINDING OF CONTEMPT OF COURT PUNISHABLE BY FINE AND OTHER APPROPRIATE SANCTIONS.

 If you fail to attend this seminar, no divorce decree will be granted where there are children under the age of 18 until both parties attend the Seminar, unless this requirement is waived by the Court for good cause shown.

BY THE COURT:

DATE: ______  _________________

1920.74(b). Form—Order Appointing Master and Scheduling Preliminary Conference.

[CAPTION]

ORDER

 AND NOW, this     day of      , 20   the Motion of Appointment of Master is GRANTED and ______ is appointed as Master.

 A Preliminary Conference is scheduled for both parties and their attorneys on     ,      , 20   at    :  .M. in Conference Room 2 on the 7th Floor of the Juvenile Justice Center, 25 S. Front Street, Harrisburg, Pennsylvania 17101.

 If economic claims have been raised of record in this case, to the extent not already filed, the non-moving party shall have ten (10) days from the date of this Order to file the documents required by Pa.R.C.P. 1920.31(a) and Pa.R.C.P. 1920.33(a). Failure to file the required documents may subject the offending party to sanctions as provided in those rules.

BY THE COURT:

PER CURIAM.

DISTRIBUTION:

Rule 1930. [A.]Mandatory Four Hour Educational [Parenting] Seminar.

[1.] (a)In all Custody, Divorce or Annulment actions in which the parties have children under the age of 18 and where a Demand for Hearing De Novo Before the Court involving child support has been filed, except for the exclusions listed below, the parties shall complete a four hour [parenting] educational seminar (Seminar for Families in Change and Conflict) if a party has not attended the Seminar in the prior twelve (12) months and in such other cases as the Court may order.

[2.] (b)In Divorce or Annulment actions in which the parties have children under the age of 18, the Plaintiff shall attend the Seminar within forty five (45) days of filing and the Defendant shall attend the Seminar within forty five (45) days from service of the complaint.

[3.] (c)In custody actions, other than Petitions for Special Relief (Emergency Custody Petitions) and Contempt, all parties must attend the Seminar before the date of their Custody Conference.

[4.] (d)In a Petition for Contempt or a Petition for Special Relief (Emergency Custody) or other similar Custody actions, the parties shall attend the Seminar as ordered by the Court.

[5.] (e)In Demands for Hearing De Novo Before the Court involving child support, the parties shall attend the Seminar prior to the hearing before the Court except in Children and Youth Appeals, emancipation cases and cases where the obligor has no assets.

[6.] (f)The fee for the Seminar must be submitted to the Provider on the date of attendance in accordance with the instructions contained in the [pamphlet] information sheet provided to all parties with their Seminar Attendance Order.

[7.] (g)If the parties have not attended the Seminar prior to their Custody Conference, the Custody Conference Officer shall provide the party with another date or time to attend the Seminar and such Order will be filed with the Prothonotary's Office.

[8.] (h)If the Custody Conference Officer recommends that it would be in the child(ren)'s best interests for a party's paramour or other adult who resides in the household or has a strong role in the parenting of the child(ren) to attend the Seminar, the Court may enter an Order requiring their attendance at the Seminar.

[9.] (i)No Parenting Plan/Custody Order will be entered or Divorce or Annulment Decree granted in cases where the parties have children under the age of eighteen (18) until all parties have completed the Seminar, unless this requirement is waived by the Court for good cause shown.

[10.] (j)Failure to attend the Seminar may be considered as Contempt of Court punishable by fine and other appropriate sanctions [including up to six (6) months incarceration].

Rule 1930.8. Self-Represented Party Entry of Appearance—Family Law Matters.

 1. All self-represented parties in family law matters shall file a written Self Represented Party Entry of Appearance in accordance with Pa.R.C.P. 1930.8 at all of their pending case dockets (custody, divorce, support, protection from abuse and paternity) where they are not represented by counsel. This form is available in the Prothonotary's Office, Domestic Relations Office and at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.

 2. All self-represented parties shall be under a continuing obligation to file an amended Self Represented Party Entry of Appearance updating the self-represented party's contact information immediately upon any change in their address, telephone number or other contact information.

 3. All self-represented parties shall provide a copy of their Self Represented Party Entry of Appearance and any updates to all other parties and attorneys of record immediately upon filing.

 4. The Self-Represented Party Entry of Appearance under this rule shall be substantially in the following form:

IN THE COURT OF COMMON PLEAS
_________________
PLAINTIFF DAUPHIN COUNTY, PENNSYLVANIA
vs.
NO. _________________
_________________
DEFENDANT

SELF-REPRESENTED PARTY ENTRY OF APPEARANCE

 1. I am the [  ] Plaintiff  [  ] Defendant in the above-captioned (MARK ONE)  [  ] custody, [  ] divorce, [  ] support,
[  ] protection from abuse, [  ] paternity case.

 2. [  ] This (MARK ONE) [  ] is [  ] is not a new case and I am representing myself in this case and have decided not to hire an attorney to represent me.

OR (check only one box)

   [  ] This is NOT a new case and ___________________________ previously
(Name of Attorney)
represented me in this case. I have decided not to be represented by that attorney and direct the Prothonotary to remove that attorney as my counsel of record in this case.

   I have provided a copy of this form to that attorney listed above at the following address:

   __________

   [  ] I am entering my appearance as a self-represented party (sign) _________________
My attorney acknowledges his/her withdrawal as my attorney in this case.
(Attorney signature) _________________ , Esq.

 3. Check one box.

   [  ] I am a victim of abuse and the other party to this action was the abuser. My address is listed on the Confidential Information Form Abuse Victim Addendum filed along with this Self-Represented Party Entry of Appearance.

   [  ] I am not an abuse victim and my address for the purpose of receiving all future pleadings and other legal notices is: ___________________________ . I understand that this address will be the only address to which notices and pleadings in this case will be sent, and that I am responsible to regularly check my mail at this address to ensure that I do not miss important deadlines or proceedings.

     [[  ] This is my home address.       [  ] This is not my home address.]

 4. Check one box.

   [  ] I am a victim of abuse and the other party to this action was the abuser. My telephone number and email address are listed on the Confidential Information Form Abuse Victim Addendum filed along with this Self- Represented Party Entry of Appearance.

   [  ] I am not the victim of abuse and my telephone number where I can be reached during normal business hours (8:00 a.m.—4:30 p.m. Monday—Friday) is ______ . My email address is ______

   [[  ] My telephone number and email address are confidential pursuant to a Protection From Abuse Order.]

 5. I UNDERSTAND I MUST FILE A NEW FORM AND CONFIDENTIAL INFORMATION FORM ABUSE VICTIM ADDENDUM (IF APPLICABLE) EVERY TIME MY ADDRESS OR TELEPHONE NUMBER CHANGES.

 6. Check one box.

   [  ] I have provided a copy of this form to all other attorneys or other self-represented parties at the following addresses as listed below: (Use reverse side if you need more space)
Name _________________ Address _________________
Name _________________ Address _________________

   [  ] I am a victim of abuse and the other party to this action was the abuser. I understand that I should only provide a copy of this form to all other attorneys or self-represented parties BUT THAT I SHOULD NOT PROVIDE A COPY OF THE CONFIDENTIAL INFORMATION FORM ABUSE VICTIM ADDENDUM TO ANYONE EXCEPT TO THE COURT BY FILING THAT FORM WITH THE APPROPRIATE FILING OFFICE (PROTHONOTARY OR DOMESTIC RELATIONS).

 7. I fully understand that by deciding to represent myself, the Court will hold me to the same standards of knowledge regarding the statutory law, evidence law, Local and State Rules of Procedure and applicable case law as a Pennsylvania licensed attorney, and that I must be fully prepared to meet those responsibilities.

   I verify that the statements made in this Entry of Appearance as a Self-Represented Party are true and correct. I understand that if I make false statements herein, that I am subject to the criminal penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities which could result in a fine and/or prison term.

   ______    ___________________________
Date            Signature (Your Signature)

   These amendments shall be effective thirty (30) days from date of publication.

   By the Court

RICHARD A. LEWIS, 
President Judge

[Pa.B. Doc. No. 18-137. Filed for public inspection January 26, 2018, 9:00 a.m.]



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