Here is the text we could read:
PETITION FOR EMERGENCY RELIEF
IN CONNECTION WITH CLAIMS OF
SEXUAL VIOLENCE OR INTIMIDATION
់់ ់ ់ ់
ត ត ជាប់ទាក់ទងន់ង
់់
់
់
តតត ត បន្ទត នត
ត
ត
ត
ត
បណ្តតង
ត សតត
ត
់ ផ្ត តវង្េទ
តតត
់ ់់
់ ់
់
តត
ករណ្ត
ត
ត
ជតនតយត ត ត សង្គ្ត ោះ
ត ត ឬការគ់រាមក់ប្ែង
ត
អ្់ព ់
ហតងា
់ ់់
់
ត
NAME and ADDRESS
ដ្មោះនិងអាសយដ្ឋាន
V. / ទល់នឹង
NAME and ADDRESS
ដ្មោះនិងអាសយដ្ឋាន
ocket No / លេខបញ្ជជបណ្ជជង៖
ជ
ជជ
ជ
ជ
Case Filed / សជណ្ជជល ឿង៖
ជ
ជ
ជ
ជជជជ
ជ
ជ
ជ
ជ
D
LAINTIFF:
ដ ើមបណ្តឹង៖
P
DEFENDANT:
ងដោទ៖
ុ
ច
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ____________
Mag. Dist. No:
លេខសមាជ េជលៅគកមស្ជ តជ
ជ
ជ ជ
ជ ជ
ជជ
ជ ជ
ជជ
ជ
ជ
ជ
DJ Name:
ល្ជ ោះលៅគកមស្ជ តជ
ជជ
ជ ជ ជ
ជជ
ជ ជ
ជ
ជ
ddress:
ជ ជ
អាសយដាជ ន
ជ
ជ
ជ
elephone:
ជ
លេខទជ សជពជ
ជ ជជ
ជជ
ជ
M
A
T
ជជ ខាង
ជជ ជជ
ជ
) (កជមា លគរជនន្ទកជ)
ជ ជ
ជ
ជ ជ
ជ ជា(ឪពជកជជ ជ ជ ឬមាជ យ)ជ (សមាជជកគរជសា លពញវ ជយ)ជ
ជជ
ជ ជ ជជ ជ
ជ
ជជ ជជ
ជមាជ កជ
ជ ជ
ជ ជ
ជ
ជជជ ជ
ជ ខាងលគោមជ ដ េមាន
ជ
ជ
ជ ជជ
ជ ជ
ផ្ទជេជ
តាងន្ទមឲ្យខជ ជន
ជ ជ
ជ
ជ ខជជជ
ជ
ជ
តាងន្ទមឲ្យអនជតជជន
ជ
ជជ
ជ ជ
លគោមជ ដ េមានខជជជ
ជ
(អាណាពាបាេ)។
តាងន្ទមឲ្យបជរជេបាតជបងជសមតជភាព
ជ
ជ
ជជជជាជ
ខ
ជ ជ
ជ
ជ អាណាពាបាេ។
ជ
ជ (កជមា
ជ ជជ
ជ ជ
ជ
ជ
ជ
ជ
ជ
ជ
ជ
On behalf of the following minor (child) (children) of whom
I am a (parent) (adult household member) (guardian).
On behalf of the following incapacitated person to whom
I am guardian.
On behalf of myself
PETITION OF THE PLAINTIFF
I, ______________________________________;
(Name of Plaintiff - please print)
hereby petition for emergency relief:
ត
ត តត
ត
បណ្តតងរបសតង្ តមង្ោទ
ត
ត
ខ
, ______________________________________;
ជជជ
ជ
ជ ជ
(សជមស លស
ជ ជ
ជ ជ
ជជ ជ
ជល្ជ ោះល ជមលោទ)
ជ ជជ ជ
៖
ជជជ ជ បន្ទជ នជ
ជ ជ
ជ
ជ
ជជនជយជ ជ ជ សលគ្ជ ោះ
ជ
ជ ជ
ស
ជ
ជមដាកជបណ្ជជង
តត ត
ជ
សជជ
តត
ជជ ជ
ជ
ជ
ជ
ជ
PLAINTIFF REQUESTS CONFIDENTIALITY OF
PERMANENT/TEMPORARY ADDRESS
ដ ើមបណ្ត
ឹងដសន
អចិន្នតយ៍/បដ្ដ ោះអាសនន
ើសុ
ុំការរក្សាភាពសម្ងា ត់ននអាសយដ្ឋា ន
ជជ
ជ )
________________________________
(Name / ល្ជ ោះ
________________________________
(Name / ល្ជ ោះ
ជ )
ជជ
ជ
ជ
_____________________________________
(Address / អាសយដាជ ន
ជ
_____________________________________
ជ
(Address / អាសយដាជ ន
ជ ជ )
ជ ជ )
ជ
ជ
ជ
____________________
(Age / អាយជ
)
ជ
____________________
)
(Age / អាយជ
ជ
ជ
The cause for seeking relief is as follows:
ជជ
មជេលេតជ
ជ ជ
ជជជ ជ
ននោ ដសជង ក
ជ
ជជ ជជនជយជ ជ ជ សលគ្ជ ោះ
ជ
ជជជ ជមាន ជរខាងលគោម៖
ជ ជ
ជជជ
ជ
ជ
ជ
ជ
ជ
ជ
ជ
MDJS 306A-BL
Petition for Emergency Relief (English/Khmer)-Translated on 6/25/2021
1
FREE INTERPRETER
នកបកប្របផ្ទា ល់មាត់ឥតគិតថ្លៃ
www.pacourts.us/language-rights
អ្
PETITION FOR EMERGENCY RELIEF
IN CONNECTION WITH CLAIMS OF
SEXUAL VIOLENCE OR INTIMIDATION
់់ ់ ់ ់
ត ត ជាប់ទាក់ទងន់ង
់់
ត ត
ត
ត
់ ផ្ត តវង្េទ
តតត
់ ់
តត
ករណ្ត
ត
ត
បណ្តតងសតតជតនតយ
ត
ត ត ឬការគ់រាមក់ប្ែង
ត
អ្់ព ់
ហតងា
់ ់់
់
់
ត ត ត សង្គ្ត ោះបន្ទត នត
តតត ត ត
់ ់់
់
ត
់
NAME and ADDRESS
ដ្មោះនិងអាសយដ្ឋាន
V. / ទល់នឹង
NAME and ADDRESS
ដ្មោះនិងអាសយដ្ឋាន
ocket No / លេខបញ្ជជបណ្ជជង៖
ជ
ជជ
ជ
ជ
Case Filed / សជណ្ជជល ឿង៖
ជ
ជ
ជ
ជជជជ
ជ
ជ
ជ
ជ
D
LAINTIFF:
ដ ើមបណ្តឹង៖
P
DEFENDANT:
ងដោទ៖
ុ
ច
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ____________
Mag. Dist. No:
លេខសមាជ េជលៅគកមស្ជ តជ
ជជ
ជ ជ
ជជ
ជ ជ
ជ
ជជ
ជ
ជ
ជ
ជជ
ល្ជ ោះលៅគកមស្ជ តជ
ជជ
DJ Name:
ជ
ជ ជ
ជ ជជ
ជ
ddress:
អាសយដាជ ន
ជ ជ
ជ
ជ
ជ
elephone:
ជ
លេខទជ សជពជ
ជ ជជ
ជជ
ជ
M
A
T
PLAINTIFF REQUESTS CONFIDENTIALITY OF
PERMANENT/TEMPORARY ADDRESS
ដ ើមបណ្ត
ឹងដសន
អចិន្នតយ៍/បដ្ដ ោះអាសនន
ើសុ
ុំការរក្សាភាពសម្ងា ត់ននអាសយដ្ឋា ន
Emergency relief from abuse is required because there
is immediate and present danger of abuse by the
defendant to me and to the above listed minor (child)
(children) (incapacitated person).
តត
ត ត គតជាកតច្តការោតបាច្តតពតង្គរោះ
ត ត
ត
ជតនតយត ត ត សង្គ្ត ោះបន្ទត នត
ត
តតត ត ត
ត
ត
ត តតដ លបងតង្ តង
ត ត
តត ភ្លត មៗ
ត
បច្តតបបនត
ត
ត
នតតតជន
ត ត
ត
ត ត
តមាត កត
ត
តត
ត ត (កតមារ
ត ត
ត
ភ្លព)តដ លបានរាយន្ទមខាងង្លត។
តត
ត
ត
ត តត
ត
ត ង្ោយច្តងង្ោទ
) (កតមារង្គច្តនន្ទកត)
ត
ត ត(បតគតលតត
តតតត
ត តត
ត
ត តត
ត
ត មានង្គរោះថ្នត កត
ត ត
តត
ត
តត ត ត
ត ត
ត ច្តង្រោះខតតតតនតងអ
ត
ត ត បាតតបងតសមតត
ត
ត ត
ត
តតត
ត
ត
ត
(Print additional names/addresses on a separate sheet of paper and attach
hereto.)
I certify that this filing complies with the provisions of the Case
Records Public Access Policy of the Unified Judicial System of
Pennsylvania that require filing confidential information and
documents differently than non-confidential information and
documents.
់
ជ
ជ
ជ
ជ
ជ ជ
ជ
ជ
ជ ជ បដនជម
ជជ
សនជជកគកដាស
ជ
ជជ ជ លៅលេជ
ជ ជ
ជ
់លដាយដែកជលេជយ
ជជ
ជ មជយជ ជ ដ្ឋច់
់
ជ
ជ /អាសយដាជ ន
ជ
ជ ជ
ជល្ជ ោះ
ជជ ជ
ជ ជ
ជ បជមកជាមជយ។)
ជ ជ
ជ
ជ
ជ
ជជ ជ
(សជមស លស
ភា
ជ
ជ ជ
ខ
ុំសូ មបញ្ជា ក្ស់ថា ការដ្ឋក្ស់ឯក្សសារដនោះអនុដោមតាមបទបញ្ញ តត
ី របស់ត្របព័នធ
ដោលការណ្៍ទទួលជាសាធារណ្ៈនូ វក្សុំណ្ត់ត្រតាដរឿងក្សដ
តុោការរ ួមននរ ា Pennsylvania ដ លតត្រមូវឲ្យដ្ឋក្ស់ព័ត៌ម្ងននិង
ឯក្សសារសម្ងា ត់ដ្ឋច់ដដ្ឋយដែក្សពីព័ត៌ម្ងននិងឯក្សសារមិនសម្ងា ត់។
ិនន
ជជ ជ
ជ ជ
ជ
__________________________________________
(Signature of the Plaintiff)
(េតជលេខា
ជ
ជ ជជ
ជ
ជជ ជ
បសជល ជមលោទ
ជជ
ជ )
ជជ
ជ
MDJS 306A-BL
Petition for Emergency Relief (English/Khmer)-Translated on 6/25/2021
2
FREE INTERPRETER
នកបកប្របផ្ទា ល់មាត់ឥតគិតថ្លៃ
www.pacourts.us/language-rights
អ្
្
ញ
(Untitled)
This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Pennsylvania 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.pacourts.us (2023-03)
- Page(s): 2
- Fields(s): 46
- Average fields per page: 23
- Reading Level: Grade 9
- LIST Grouping(s):
GO-00-00-00-00.
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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.
county
was County (0.54 conf)md_j_number
was MDJ Number (0.45 conf)md_j_name
was MDJ Name (0.40 conf)md_j_add
was MDJ_Add1 (0.43 conf)md_j_phone
was MDJ Phone (0.39 conf)plaintiff_name
was Plaintiff Name (0.50 conf)plaintiff_address__1
was Plaintiff Address 1 (0.48 conf)plaintiff_address__2
was Plaintiff Address 2 (0.48 conf)defendant_name
was DefendantName (0.41 conf)defendant_address__1
was DefendantAddress_1 (0.42 conf)defendant_address__2
was DefendantAddress_2 (0.42 conf)docket
was Docket_No (0.36 conf)date_filed
was Date_Filed (0.44 conf)check_box__1
was CheckBox1 (0.52 conf)check_box__2
was CheckBox1_T (0.52 conf)users1_name
was Name (1.00 conf)name
was Name_T (0.41 conf)check_box__3
was CheckBox2 (0.37 conf)check_box__4
was CheckBox2T (0.41 conf)check_box__5
was CheckBox3 (0.37 conf)check_box__6
was CheckBox3T (0.41 conf)check_box__7
was CheckBox4 (0.37 conf)check_box__8
was CheckBox4T (0.41 conf)bottom_name__1
was Bottom Name (0.40 conf)users1_address_line_one
was Address (1.00 conf)age__1
was Age (0.36 conf)bottom_name__2
was Bottom Name2 (0.31 conf)address
was Address2 (0.35 conf)age__2
was Age2 (0.35 conf)cause__1
was Cause (0.45 conf)cause__2
was CauseT (0.35 conf)county_b
was CountyB (0.37 conf)md_j_number_b
was MDJ NumberB (0.39 conf)md_j_name_b
was MDJ NameB (0.35 conf)md_j_add_b
was MDJ_Add1B (0.37 conf)md_j_phone_b
was MDJ PhoneB (0.39 conf)plaintiff_name_b
was Plaintiff NameB (0.49 conf)plaintiff_address_b__1
was Plaintiff Address 1B (0.46 conf)plaintiff_address_b__2
was Plaintiff Address 2B (0.46 conf)defendant_name_b
was DefendantNameB (0.34 conf)defendant_address_b__1
was DefendantAddress_1B (0.37 conf)defendant_address_b__2
was DefendantAddress_2B (0.37 conf)docket_b
was Docket_NoB (0.37 conf)date_filed_b
was Date_FiledB (0.46 conf)check_box_b
was CheckBox1B (0.49 conf)check_box_tb
was CheckBox1_TB (0.36 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
Suggested Screen 1:
plaintiff_name
defendant_name
name
Suggested Screen 2:
Suggested Screen 3:
Suggested Screen 4:
check_box__1
check_box__2
check_box__3
check_box__4
check_box__5
check_box__6
check_box__7
check_box__8
check_box_b
check_box_tb
Suggested Screen 5:
Suggested Screen 6:
md_j_number
md_j_name
md_j_add
md_j_phone
county_b
md_j_number_b
md_j_name_b
md_j_add_b
md_j_phone_b
Suggested Screen 7:
plaintiff_address__1
plaintiff_address__2
defendant_address__1
defendant_address__2
users1_name
bottom_name__1
users1_address_line_one
age__1
bottom_name__2
age__2
cause__1
cause__2
plaintiff_name_b
plaintiff_address_b__1
plaintiff_address_b__2
defendant_name_b
defendant_address_b__1
defendant_address_b__2
docket_b
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