Local Rules of Court

Form 7

IN THE COURT OF COMMON PLEAS OF LANCASTER COUNTY, PENNSYLVANIA CIVIL ACTION

[CAPTION]

CONSUMER CREDIT CARD COLLECTION DIVERSION PROGRAM AFFIDAVIT OF COMPLIANCE AND ENTITLEMENT TO DEFAULT JUDGMENT

Please check one:

[ ]

I am an unrepresented plaintiff

[ ]

I am counsel for the plaintiff

The undersigned hereby states that:

1. I have personally reviewed the documentation filed and served in this action pursuant to Local Rule 205.2(d) (as may be amended).

2. The documentation meets all requirements of Lancaster County Local Rule 205.2 (d) (as may be amended), with any exceptions specifically stated here:

.

3. The documentation establishes the plaintiff’s entitlement to judgment in the amount claimed.

Plaintiff / Counsel for Plaintiff

Date

[Email Address, Telephone Number]