Rule 2967. Petition to Strike Judgment. Form

The petition to strike judgment required by Rules 2958.3 and 2973.3 shall be substantially in the following form:

(Caption)

PETITION TO STRIKE JUDGMENT

REQUEST FOR PROMPT HEARING

I hereby certify that I did not voluntarily, intelligently and knowingly give up my right to notice and hearing prior to the entry of judgment. I petition the court to strike the judgment on this ground and request a prompt hearing on this issue.

I verify that the statements made in this Request for Hearing are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities.

Notice of the hearing should be given to me at

Street Address City, State Telephone Number

Dated: … Defendant(s)