Section 1313. Form of Notice of Appeal

(a) The notice of appeal shall be in substantially the following form:

(Caption)
NOTICE OF APPEAL
FROM AWARD OF BOARD OF ARBITRATORS

TO THE PROTHONOTARY:

Notice is given that

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appeals from the award of the board of arbitrators entered in this case on

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.

A jury trial is demanded . [Check box if a jury trial is demanded. Otherwise jury trial is waived.)

I hereby certify that

(1) the compensation of the arbitrators has been paid,

or

(2) application has been made for permission to proceed in forma pauperis. (Strike out the inapplicable clause.)

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Appellant or Attorney for Appellant

Official Note

The demand for jury trial on appeal from compulsory arbitration is governed by Rule 1007.1(b).

(b) No affidavit or verification is required.