Phil. Cnty. Pa. 110

As amended through December 18, 2021

Rule 110 - Claim Fact Sheet For Personal Injury And Property Damage Actions

a. Complaints for damages as a result of injuries to persons or property, if in excess of $2,000, shall have annexed thereto a completed Claim Fact Sheet, verified by the claimant.

b. Any party may supplement the same twenty (20) days or more prior to trial.

c. The Court may permit amendment or supplementation of the Claim Fact Sheet at any time for good cause shown.

d. Information not included in the Claim Fact Sheet shall not be admissible at trial.

e. The Claim Fact Sheet shall be substantially in the following form:

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(Instructions: This completed form should be attached to your complaint. Use additional sheets of paper if necessary. If the claimant is a corporation, it should execute this form in accordance with the following example: XYZ Corporation by John Jones, President. If you obtain additional information requested by this Claim Fact Sheet, you should immediately send the defendant(s) a supplementary Claim Fact Sheet and file a copy with the court with an affidavit of service twenty (20) days or more prior to trial. Failure to do so may result in the exclusion of this information at trial.)

Phil. Cnty. Pa. 110