Rule 1012 - Self-Represented Party Entry Of Appearance - Non Family Law Civil Actions1. Each self-represented party in all civil actions other than family law matters shall file a written Self Represented Party Entry of Appearance in accordance with Pa.R.C.P. 1012. (for family law matters, see Local 1930.8) . A Self Represented Party Entry of Appearance form is available in the Prothonotary's Office and at www.dauphincounty.org/government/Court-Departments/Self-Help-Center.2. Each self-represented party shall be under a continuing obligation to file an amended Self-Represented Party Entry of Appearance with the Prothonotary's Office updating the self-represented party's contact information immediately upon any change.3. Each self-represented party shall provide a copy of his or her Self Represented Party Entry of Appearance and any updates to all other parties and attorneys of record immediately upon filing.4. The assertion of self-representation shall not delay any stage of the proceeding, absent good cause shown.5. The Self-Represented Party Entry of Appearance under this rule shall be substantially in the following form: IN THE COURT OF COMMON PLEAS
___________________________
PLAINTIFF
DAUPHIN COUNTY, PENNSYLVANIA
vs.
NO. _____________________________
_____________________________
DEFENDANT
SELF-REPRESENTED PARTY ENTRY OF APPEARANCE
1. I am the Plaintiff Defendant in the above-captioned case and have chosen to represent myself.2. My address for the purpose of this case and for serving me with all future pleadings and other legal notices is: _______________________________________________________. I understand that this address will be the only address to which notices and pleadings in this case will be sent, and that I am responsible to regularly check my mail at this address to ensure that I know of important deadlines or scheduled proceedings.
3. My telephone number where I can be reached during normal business hours (8:00 a.m. 4:30 p.m. Monday Friday) is ______________________________________. My Email is ___________________________________.
4. I UNDERSTAND I MUST FILE A NEW FORM EVERY TIME MY ADDRESS OR TELEPHONE NUMBER CHANGES.5. I certify that I have provided a copy of this form to all other attorneys or other self-represented parties at the following addresses as listed below: (Use reverse side if you need more space) Name______________________________ Address__________________________________________________
Name______________________________ Address__________________________________________________
Name______________________________ Address__________________________________________________
Name______________________________ Address__________________________________________________
6.I fully understand that by deciding to represent myself, the Court will hold me to the same standards of knowledge regarding the statutory law, evidence law, Local and State Rules of Procedure and applicable case law as a Pennsylvania licensed attorney, and that I must be fully prepared to meet those responsibilities.I verify that the statements made in this Entry of Appearance as a Self-Represented Party are true and correct. I understand that if I make false statements herein, that I am subject to the criminal penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities which could result in a fine and/or prison term.
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Date
__________________
Signature (Your Signature)