Free 02-63 Withdrawal of Counsel - Pennsylvania

FIRST JUDICIAL DISTRICT OF PENNSYLVANIA PHILADELPHIA TRAFFIC COURT Commonwealth of Pennsylvania vs. _____________________________ Defendant's Name REQUEST FOR LEAVE TO WITHDRAW AS COUNSEL
Defendant's Name OLN

Citation No(s).

Address

City

State

Zip

Name of Defendant's Attorney

Attorney ID #

Office Address

City

State

Zip

Electronic Mail Address of Attorney:

Date of Trial

Time

Courtroom (If Available)

Reason for Request to Withdraw (Attach all necessary documentation)

Defendant's Position

I verify that the statements made herein are true and correct, and that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to authorities. _____________________________________________ Signature of Attorney ORDER Counsel's request to withdraw as counsel for the Defendant is: Granted. Reason: Denied. Reason: BY THE COURT: ___________________ Date

Date: ______________

_____________________________________________ TRAFFIC COURT JUDGE

02-63