Civil Cover Sheet Page 8
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22NAME OF FILING PARTY:
___________________________________
Name
___________________________________
Address
___________________________________
City, State, Zip
___________________________________
Telephone
___________________________________
______________________________
:
PHILADELPHIA COUNTY
:
COURT OF COMMON PLEAS
______________________________
:
TRIAL DIVISION - CIVIL
Plaintiff
:
:
vs.
:
_________ TERM, _____________
Month
Year
:
______________________________
:
:
No. ________________________
______________________________
:
Defendant
:
AFFIDAVIT OF PLAINTIFF
COMMONWEALTH OF PENNSYLVANIA
:
:
ss.
COUNTY OF PHILADELPHIA
:
I, _____________________________ (Plaintiff), being duly sworn according to
law, depose and say that the facts stated herein are true and correct.
________________________________
Plaintiff
__________________________________
Plaintiff
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