The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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Here is the text we could read:

This information is requested to help police identify and locate the Respondent in order to serve the Respondent
with any summons or execute any warrant of apprehension pursuant to G.L. c. 123 § 35. Please provide as much
information as possible.

RESPONDENT'S NAME

OTHER NAMES USED BY RESPONDENT, IF ANY

rial Court of Massachusetts

DOCKET NO. (for court use only)

RESPONDENT INFORMATION FORM
AS PROVIDED BY PETITIONER
G.L. c. 123 § 35

RESPONDENT'S DATE OF BIRTH

RESPONDENT'S PLACE OF BIRTH

RESPONDENT'S SOCIAL SECURITY NUMBER

MOTHER'S MAIDEN NAME (FIRST, LAST)

FATHER'S NAME (FIRST, LAST)

SEX

MALE

RACE

FEMALE

PHOTO AVAILABLE
(HELPFUL FOR ID)

PLEASE ATTACH

YES

EYE COLOR

HAIR COLOR

HEIGHT

WEIGHT

BUILD

OTHER PHYSICAL CHARACTERISTICS (beard, glasses, scars, tattoos, complexion, hairstyle)

RESPONDENT'S HOME ADDRESS (NO,, STREET, CITY, STATE, ZIP CODE)

APT NO.

FLOOR NO.

NAME ON DOOR/MAILBOX

RESPONDENT'S HOME PHONE NO. RESPONDENT'S CELL PHONE NO. DOES THE RESPONDENT
UNDERSTAND ENGLISH?

IF NOT, WHAT LANGUAGES?

YES
NO

RESPONDENT'S EMPLOYER/WORKPLACE

TITLE

DEPARTMENT

WORK ADDRESS (NO., STREET, CITY, STATE, ZIP CODE)

WORK TELEPHONE NO.

WORK HOURS

OTHER PLACES RESPONDENT MAY BE FOUND (friends, bars, relatives, hangouts)

BEST PLACE TO FIND RESPONDENT BEST TIME TO FIND RESPONDENT

MOTOR VEHICLE LICENSE PLATE

YEAR

MAKE

MODEL

COLOR

DOES THE RESPONDENT HAVE: (describe briefly)

A history of violence toward police officers?

YES

A history of using/abusing drugs or alcohol? If so,
what kind?
Access to guns, a license to carry, or possess a gun?
If so, what kind?

YES

Psychiatric/emotional problems? If so, what kind?
Any other information which might be helpful in locating the Respondent:

YES

DATE SIGNED

PETITIONER'S NAME (printed)

PETITIONER'S SIGNATURE

(Rev. 4/16)

Respondent Information Form as Provided by Petitioner

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Massachusetts state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.mass.gov (2023-03)
Page(s): 1
Fields(s): 60
Average fields per page: 60
Reading Level: Grade 9
LIST Grouping(s): CR-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

docke_n_court_use was DOCKET NO for court use only (0.69 conf)
respondent_name was RESPONDENTS NAME (0.39 conf)
othe_r_name_use_b_f was OTHER NAMES USED BY RESPONDENT IF ANY (0.33 conf)
respondent_dat_e_f_birth was RESPONDENTS DATE OF BIRTH (0.43 conf)
responden_plac_e_f_birth was RESPONDENT S PLACE OF BIRTH (0.45 conf)
respondent_socia_l_securit_number was RESPONDENTS SOCIAL SECURITY NUMBER (0.41 conf)
mother_maide_n_nam_e_last was MOTHERS MAIDEN NAME FIRST LAST (0.46 conf)
father_nam_e_firs_last was FATHERS NAME FIRST LAST (0.43 conf)
race was RACE (0.41 conf)
ey_e_color was EYE COLOR (0.48 conf)
hai_r_color was HAIR COLOR (0.35 conf)
height was HEIGHT (0.36 conf)
weight was WEIGHT (0.36 conf)
build was BUILD (0.33 conf)
scars_complexion_hairstyle was OTHER PHYSICAL CHARACTERISTICS beard glasses scars tattoos complexion hairstyle (0.44 conf)
hom_e_addres_n_cit_zi was RESPONDENTS HOME ADDRESS NO STREET CITY STATE ZIP CODE (0.43 conf)
ap was APT NO (0.40 conf)
floo_r was FLOOR NO (0.48 conf)
nam_e_n_doormailbox was NAME ON DOORMAILBOX (0.56 conf)
responden_hom_e_phon was RESPONDENT S HOME PHONE NO (0.47 conf)
responden_cel_l_phon_e was RESPONDENT S CELL PHONE NO (0.42 conf)
f_wha_languages was IF NOT WHAT LANGUAGES (0.34 conf)
responden_employerworkplace was RESPONDENT S EMPLOYERWORKPLACE (0.34 conf)
title was TITLE (0.27 conf)
department was DEPARTMENT (0.40 conf)
wor_k_n_cit_e_zi_p was WORK ADDRESS NO STREET CITY STATE ZIP CODE (0.49 conf)
wor_k_telephon_e was WORK TELEPHONE NO (0.55 conf)
wor_k_hours was WORK HOURS (0.38 conf)
othe_r_place_friends_relatives was OTHER PLACES RESPONDENT MAY BE FOUND friends bars relatives hangouts (0.45 conf)
bes_plac_e_fin_respondent was BEST PLACE TO FIND RESPONDENT (0.49 conf)
bes_tim_e_fin_respondent was BEST TIME TO FIND RESPONDENT (0.48 conf)
moto_r_vehicl_e_licens_plate was MOTOR VEHICLE LICENSE PLATE (0.50 conf)
year was YEAR (0.28 conf)
make was MAKE (0.39 conf)
model was MODEL (0.31 conf)
color was COLOR (0.39 conf)
no was NO (0.45 conf)
n__1 was NO_2 (0.41 conf)
n__2 was NO_3 (0.41 conf)
n__3 was NO_4 (0.41 conf)
undefined__1 was undefined (0.38 conf)
undefined__2 was undefined_2 (0.39 conf)
undefined__3 was undefined_3 (0.39 conf)
dat_e_signed was DATE SIGNED (0.43 conf)
petitioner_nam_e_printed was PETITIONERS NAME printed (0.43 conf)
petitioner_signature was PETITIONERS SIGNATURE (0.47 conf)
check_box__1 was Check Box1 (0.52 conf)
check_box__2 was Check Box2 (0.37 conf)
check_box__3 was Check Box3 (0.37 conf)
check_box__4 was Check Box4 (0.37 conf)
check_box__5 was Check Box5 (0.37 conf)
check_box__6 was Check Box6 (0.37 conf)
check_box__7 was Check Box7 (0.37 conf)
check_box__8 was Check Box8 (0.37 conf)
check_box__9 was Check Box9 (0.37 conf)
check_box__10 was Check Box10 (0.37 conf)
check_box__11 was Check Box11 (0.37 conf)
check_box__12 was Check Box12 (0.37 conf)
check_box__13 was Check Box13 (0.37 conf)
check_box__14 was Check Box14 (0.37 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Respondent Information Form as Provided by Petitioner

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Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02