IN THE COURT OF COMMON PLEAS FOR ADAMS COUNTY, PENNSYLVANIA CIVIL ACTION - LAW
Name1(CICForm)
NamePLAINTIFF
vs.
NameDEFENDANT 1
and (if applicable)
NameDEFENDANT 2
Name2(CICForm)
Name3(CICForm)
Case(CICForm)
CASE NO. _____
CERTIFICATE OF COMPLIANCE
I certify that this filing complies with the provisions of the Case Record Public Access Policy of the Unified Judicial System of Pennsylvania: Case Records of the Appellate and Trial Courts that require filing confidential information and documents differently than non-confidential information and documents.
Signature: _____
Petitioner Date: _____
Print Name: _____
Name4(CICForm)
Date:
Date(CICForm)