(Caption)
NOTICE OF APPEAL
FROM AWARD OF BOARD OF ARBITRATORS
TO THE PROTHONOTARY:
Notice is given that ______________________________________
appeals from the award of the board of arbitrators entered in this case on
____________.
A jury trial is demanded [] Check box if a jury trial is demanded. Otherwise jury trial is waived.)
I hereby certify that
or
_____________________________________
Appellant or Attorney for Appellant
231 Pa. Code r. 1313