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This is a Pennsylvania form that can be used for Court Of Common Pleas within Local County, Dauphin.
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Plaintiff(s) V. Defendant(s) : IN THE COURT OF COMMON PLEAS : DAUPHIN COUNTY, PENNSYLVANIA : : : : NO. : : : : Praecipe for Notice of Intent to Attach Wages To the Prothonotary: Issue a Notice of Intent to Attach Wages in the above matter (1) against , Defendant (2) against , Employer of the Defendant. Date : Attorney for Judgment Creditor-Landlord or Judgment Creditor-Landlord if unrepresented Address Address Telephone Number American LegalNet, Inc. www.USCourtForms.com Certification by Judgment Creditor - Landlord I certify that 1. The Plaintiff judgment-creditor is Name Address Address 2. The Defendant judgment-debtor is Name Address Address 3. The Employer Garnishee is Name Address Address 4. The judgment arises out of a residential lease for the premises at (address). 5. (a) (b) The amount of the judgment is $ A security deposit in the amount of $ the judgment creditor-landlord. This security deposit has been applied is being held by has not been applied to payment of rent due on the same premises for which the judgment has been entered. (Any security deposit that has not already been applied to rent will be deducted by the Prothonotary from the amount of the judgment in determining the amount to be attached.) (c) The amount of $ has been paid toward satisfaction of the judgment. (Do not include the security deposit.) American LegalNet, Inc. www.USCourtForms.com 6. This Praecipe is filed within five years of the date of the original judgment upon which execution is sought. The judgment was entered (check one) : in a civil action commenced in the Court of Common Pleas in an action brought before a Magisterial District Judge in an action commenced in the Philadelphia Municipal Court 7. 8. Check the appropriate paragraph and attach the required documents : (a) If the judgment was entered in a civil action (Pa.R.C.P.M.D.J. 301 et seq.) before a Magisterial District Judge, a copy of the Complaint filed with the Magisterial District Judge is attached to this Notice, showing that the action arose from a residential lease. If the judgment was entered in an action for the recovery of possession of real property (Pa.R.C.P.M.D.J. 501 et seq.) before a Magisterial District Judge, copies of the appropriate Magisterial District Judge records are attached showing that the action arose from a residential lease and that the Defendant appeared or filed papers in that action or that the Complaint was served by handing a copy to the Defendant. If the judgment was entered in an action in the Philadelphia Municipal Court in which the Defendant was served pursuant to Phila.M.C.R.Civ.P. No. 111(A) or (C), a copy of the Complaint filed with the Philadelphia Municipal Court is attached to this Notice, showing that the action arose from a residential lease. If the judgment was entered in an action in the Philadelphia Municipal Court in which the Defendant was served pursuant to Phila.M.C.R.Civ.P. No. 111(B), copies of the appropriate Philadelphia Municipal Court records are attached showing that the Defendant appeared or filed papers in the action. (b) (c) (d) I certify that the statements made in this Certification 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 : Judgment Creditor-Landlord American LegalNet, Inc. www.USCourtForms.com