The petition to strike judgment required by Rules 2958.3 and 2973.3 shall be substantially in the following form:
(Caption)
PETITION TO STRIKE JUDGMENT
____________
REQUEST FOR PROMPT HEARING
I hereby certify that I did not voluntarily, intelligently and knowingly give up my right to notice and hearing prior to the entry of judgment. I petition the court to strike the judgment on this ground and request a prompt hearing on this issue.
I verify that the statements made in this Request for Hearing 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.
Notice of the hearing should be given to me at
______________________________________
Street Address
______________________________________
City, State
______________________________________
Telephone Number
Dated: ____________ | _________________________ |
Defendant(s) |
231 Pa. Code r. 2967