FORM:
CIVIL DIVISION-LAW
_________________,
:
Plaintiff
:
:
vs.
:
:
_________________,
:
Defendant
:
No.
CERTIFICATE OF COMPLIANCE FOR 1915d
I certify that I have complied with Local 1915d as noted below.
[ ] Talked by phone | _________________ (date) |
[ ] Met in Person | _________________ (date) |
[ ] Telephoned/Left message | _________________ (date) |
[ ] Emailed | _________________ (date) |
[ ] Emergency | _________________ _________________ |
[ ] Other: | _________________ _________________ |
[ ] Domestic Violence Waiver | ________________ |
[ ] Unable to Confer because: | _________________ _________________ |
_________________ Date | _________________ Signature _________________ Print Name |
Beav. Cnty. Pa. 208.3(b)