37 Pa. Code § 197.6 - Form of certificate of service
COMMONWEALTH OF PENNSYLVANIA
STATE HEALTH FACILITY HEARING BOARD
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IN RE: |
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DOCKET NO. |
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CERTIFICATE OF SERVICE
I hereby certify that on or before the date of filing the following document(s):
____________________________________________
I have served a copy thereof on each of the following persons in the manner indicated below:
Service by first class mail addressed as follows:
____________________________________________
(Name and Address)
Service in person:
____________________________________________
(Name and Address)
Acceptance of service endorsed by the following:
____________________________________________
(Name and Address)
______________________
(Signature of Person Filing)
______________________
(Name and Address of Person Filing)
______________________
(Date)
Notes
The provisions of this § 197.6 amended under section 805(b) of the Health Care Facilities Act (35 P. S. § 448.805(b)); and 2 Pa.C.S. § 102(a).
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