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Notice Of Appeal From Summary Criminal Conviction - Pennsylvania
| Notice Of Appeal From Summary Criminal Conviction Form. This is a Pennsylvania form and can be used in Criminal Court Of Common Pleas Northampton Local County . |
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IN THE COURT OF COMMON PLEAS, COUNTY OF NORTHAMPTON Notice of Appeal from Summary Criminal Conviction Name and Address of Defendant: Date ____________________ __________________________________________________ Issuing Authority Docket No. ________________________________ __________________________________________ Citation No. ______________________________________________ __________________________________________ Date of Birth _______________________________________ Magisterial District No. ____________________________________ Appeal from Sentence of: __________________________________________________________________________ Date of Sentence: ________________ Offense(s) of which convicted ______________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Name and Mailing Address of Affiant as shown on Citation or Complaint: ___________________________________________________ ___________________________________________________ ___________________________________________________ If sentence includes fine and costs, amount of which paid: _________________________________________________________ Type or amount of bail furnished to issuing authority, if any: _________________________________________________________ Name and address of issuing authority: ___________________________________________________ Name and Address of Attorney for Defendant: Attorney Identification No. (Signature) _______________________________________________ ___________________________________________________ (Print Name)______________________________________________ ___________________________________________________ (Address) ________________________________________________ Phone: _____________________________________________ _____________________________(Phone) _____________________ Clerk of Courts (White) Defendant's Copy (Green) Magisterial District Justice (Yellow) District Attorney (Pink) Affiant's Copy (Golden Rod) American LegalNet, Inc. www.FormsWorkflow.com American LegalNet, Inc. www.FormsWorkflow.com
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