231 Pa. Code Rule 1930.8
(c) When a party has an attorney of record, the party may assert his or her self-representation by:
(f) The entry of appearance of a self-represented party shall be substantially in the following form:
I,
, Plaintiff or Defendant (circle one), represent myself in the within action.
REMOVAL OR WITHDRAWAL OF COUNSEL OF RECORD (If Applicable)
Remove
, Esq., as my attorney of record.
Withdraw my appearance for the filing party.
Esq. (Print name)ID#
SignatureDATE:
I understand that I am under a continuing obligation to provide current contact information to the court, to other self-represented parties, and to attorneys of record.
All pleadings and legal papers can be served on me at the address listed below, which may or may not be my home address pursuant to Rule 1930.8:
Print Name
SignatureTelephone number
AddressFAX
City, State, Zip CodeDate
THE PARTY FILING THIS ENTRY OF APPEARANCE MUST PROVIDE NOTICE BY SENDING A COPY TO ALL PARTIES AND ATTORNEYS, INCLUDING THE ATTORNEY REMOVED FROM THE CASE.
Official Note
This form cannot be used when filing for support through the Department of Public Welfare Bureau of Child Support Enforcement’s E-Services program. An entry of appearance form is available on the E-Services site for individuals filing through that program.
Explanatory Comment—2013
Withdrawal of appearance by counsel of record without the entry of appearance by a self-represented party is governed by Pa.R.C.P. No. 1012. Service of original process in domestic relations matters is governed by Pa.R.C.P. No. 1930.4. Service of legal papers other than original process is governed by Pa.R.C.P. No. 440.
The provisions of this Rule 1930.8 adopted June 5, 2013, effective in 30 days on July 5, 2013, 43 Pa.B. 3329; amended March 4, 2015, effective in 30 days on April 3, 2015, 45 Pa.B. 1354. Immediately preceding text appears at serial pages (372675) to (372676).