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                   DEFENDANT IDENTIFIERS 
DOB 
SEX 
RACE 
HAIR 
SSN 
DRIVERS 
LICENSE # 
EXP DATE 

 
 
 
 
 

 

 

HEIGHT 
WEIGHT 
EYES 

 
 
 

FINAL PROTECTION FROM 
ABUSE   
 Extended Order    Amended Order 

IN THE COURT OF COMMON PLEAS OF 
_____________________ COUNTY, PENNSYLVANIA 
NO. 

First 

 

    Middle  

     Last 

 

     Plaintiff’s DOB 

Name(s) of all protected persons, including minor child/ren and DOB: 

_________________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________________ 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

     Middle 

     Last 

 

     Suffix 

 

 

 

 

 
 
DEFENDANT 

V. 

   

First 

Defendant’s address: 

 

 

 

 

LAINTIFF 

  P

   

_________________________________________________________ 

_________________________________________________________ 

CAUTION: 
  Weapon Involved 
  Weapon Present on Property 
  Weapon Ordered Relinquished 
____________________________________________________________________________________________________ 

STATE 

 

The Court Hereby Finds:  That it has jurisdiction over the parties and subject matter, and Defendant has been provided 
with reasonable notice and opportunity to be heard. 

The Court Hereby Orders:  
  Defendant shall not abuse, harass, stalk, threaten, or attempt or threaten to use physical force against any of the above persons in 

any place where they might be found. 

  Except as provided in Paragraph 5 of this order, Defendant shall not contact Plaintiff, or any other person protected under  
      this order, by telephone or by any other means, including through third persons. 
  Additional findings of this order are set forth below. 

Order Effective Date____________________________  Order Expiration date______________________________ 
____________________________________________________________________________________________________ 
 
NOTICE TO DEFENDANT 
 

DEFENDANT IS HEREBY NOTIFIED THAT FAILURE TO OBEY THIS ORDER MAY RESULT IN ARREST AS SET FORTH IN 23 PA.C.S. § 6113 AND THAT 
VIOLATION OF THE ORDER MAY RESULT IN A CHARGE OF INDIRECT CRIMINAL CONTEMPT AS SET FORTH IN 23 PA.C.S. § 6114. VIOLATION MAY 
ALSO SUBJECT YOU TO PROSECUTION AND CRIMINAL PENALTIES UNDER THE PENNSYLVANIA CRIMES CODE.  A VIOLATION OF THIS ORDER 
MAY RESULT IN THE REVOCATION OF THE SAFEKEEPING PERMIT, WHICH WILL REQUIRE THE IMMEDIATE RELINQUISHMENT OF YOUR 
FIREARMS, OTHER WEAPONS, OR AMMUNITION TO THE SHERIFF OR THE APPROPRIATE LAW ENFORCEMENT AGENCY.  PLAINTIFF’S CONSENT 
TO CONTACT BY DEFENDANT SHALL NOT INVALIDATE THIS ORDER WHICH CAN ONLY BE MODIFIED BY FURTHER ORDER OF COURT.  23 Pa C.S. 
§6108(g). 

HIS ORDER IS ENFORCEABLE IN ALL FIFTY (50) STATES, THE DISTRICT OF COLUMBIA, TRIBAL LANDS, U.S. TERRITORIES, AND THE 

COMMONWEALTH OF PUERTO RICO UNDER THE VIOLENCE AGAINST WOMEN ACT, 18 U.S.C.  §2265. IF YOU TRAVEL OUTSIDE OF THE STATE AND 
INTENTIONALLY VIOLATE THIS ORDER YOU MAY BE SUBJECT TO FEDERAL CRIMINAL PROCEEDINGS UNDER THAT ACT.  18 U.S.C. §§2261-2262.  IF 
YOU POSSESS A FIREARM OR ANY AMMUNITION WHILE THIS ORDER IS IN EFFECT, YOU MAY BE CHARGED WITH A FEDERAL CRIMINAL OFFENSE 
EVEN IF THIS PENNSYLVANIA ORDER DOES NOT EXPRESSLY PROHIBIT YOU FROM POSSESSING FIREARMS OR AMMUNITION  UNDER 18 U.S.C. 
§922(g)(8) OR STATE CRIMINAL OFFENSES AND STATE CRIMINAL PENALTIES UNDER 18 PA.C.S. § 6105. 

 

 

 

   

 

 

 

 

  T

         

ENGLISH/ARABIC PFA Final Order 
Pa. R.C.P 1905(e) Rev. 3-19 

                    Page 1 of 9 / 9 ﻦﻣ 

 
 1 ﺔﺤﻔﺻ 

   AOPC Rev. 4-2019 

ﺪﺿ 

 

 
 
ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا

 

   

 

 

( 

رﻮﯿﻧﻮﺟ

 ،ﻞﺜﻣ) ﺔﯿ

ﻓﺮﺣ ﺔﻘﺣﻻ

  

 

      

ﺔﻠﺋﺎﻌﻟا ﻢﺳا

 

      

ﻂﺳوﻷا ﻢﺳﻻا
 

 

لوﻷا ﻢﺳﻻا

 

ﻲﻋﺪﻤﻟا

 

 

ﻲﻋﺪﻤﻟا

 د

ﻼﯿﻣ

 ﺦﯾ

رﺎﺗ

           

     

 

ﺔﻠﺋﺎﻌﻟا ﻢﺳا

                       

 

ﻂﺳوﻷا ﻢﺳﻻا

                                    

  

لوﻷا ﻢﺳﻻ

   

 

 

 

 

 

 

 

 

 
 (ءﺎﻤﺳأ) ﻢﺳا
_______________________________________________________________________________________________________

:دﻼﯿﻤﻟا ﺦﯾرﺎﺗو ﺮﺻﺎﻘﻟا (لﺎﻔطﻷا) ﻞﻔﻄﻟا ﻢﮭﯿﻓ ﻦ

ﻤﺑ ،ﻦﯿﯿﻤﺤﻤﻟا صﺎﺨﺷﻷا
 

ﻊﯿﻤﺟ

_______________________________________________________________________________________________________

   

 

 

 

 

 

 

 

ﺎﯿﻧﺎﻔﻠﺴﻨﺑ

 ،

_________________

 ﺔﻌطﺎﻘﻤﻟ ﺔﻣﺎﻌﻟا

ﺔﯿﺋاﺪﺘﺑﻻا ﺔﻤﻜﺤﻤﻟا ﻲﻓ
 
ﻢﻗر 

 
ّﺪﻌﻣ ﺮﻣأ
ل
  
 

 
ةءﺎﺳإ ﻦﻣ ﺔﯾﺎﻤﺣ
   
ﺮﻤﺘﺴﻣ ﺮﻣأ  
 

 

  

 

   

 
 
حﻼﺳ كﺎﻨھ
 ﻲﻓ دﻮﺟﻮﻣ حﻼﺳ كﺎﻨھ
ﻢﯿﻠﺴﺘﺑ ﺮﻣأ رﺪﺻ

 

 حﻼﺴﻟا

:ﮫﯿﺒﻨﺗ
 
 
 

 

رﺎﻘﻌﻟا
 

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
 

فﺎﺻوأ
 

 
لﻮﻄﻟا
نزﻮﻟا
 
ﻦﯿﻨﯿﻌﻟا

 

ﺔﯾ

ﻻﻮﻟا

 

 
 
 

 

 

دﻼﯿﻤﻟا ﺦﯾرﺎﺗ
 
ﺲﻨﺠﻟا
 
ق ْﺮِﻌﻟا
 
ﺮﻌﺸﻟا
ﻤﻀﻟا
ﻗر ﻢ
ةدﺎﯿﻘﻟا ﺔﺼﺧر ﻢﻗر
ﺎﮭ
ﺘﻧا ﺦﯾرﺎﺗ

ا نﺎ

 

ﻲﻋﺎﻤﺘﺟﻻ
 

 

ﺔﯿﺣﻼﺼﻟا ء

ﻰﻋﺪﻤﻟا ناﻮﻨﻋ
_____________________________________________
 
_____________________________________________

:ﮫﯿﻠﻋ
 

 

 

 

 

ﮫﯿﻟإ عﺎﻤﺘﺳﻼﻟ ﻦﯿﻟﻮﻘﻌﻤﻟا ﺔﺻﺮﻔﻟاو رﺎﻌﺷﻹﺎﺑ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﺪﯾوﺰﺗ ﻢ
. 

_____________________________________________________________________________________________________
 
رﺮﻘﺗ
 
ﺒﺟﻮﻤﺑ ﺔﻤﻜﺤﻤﻟا ﺮﻣﺄﺗ
  
.ﮫﯿﻓ
 
  

ﺺﺨﺷ يأ وأ ،ﻲﻋﺪﻤﻟﺎﺑ لﺎﺼﺗﻻا ﻦﻣ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻊﻨﻤُﯾ ،

 نوﺪﺟاﻮﺘﯾ ﺪﻗ نﺎﻜﻣ يأ ﻲﻓ هﻼﻋأ صﺎﺨﺷﻷا ﻦﻣ يأ

 ﺔﯾﺪﺴﺠﻟا ةﻮﻘﻟا ماﺪﺨﺘﺳا ﺔﻟوﺎﺤﻣ وأ
 

ﺪﯾﺪﮭﺗ وأ ﺐّﻘﻌﺗ وأ ﺔﻘﯾﺎﻀﻣ وأ
 

ﺗو ،عﻮﺿﻮﻤﻟاو فاﺮطﻷا ﻰﻠﻋ
 

ﺔﯿﺋﺎﻀﻘﻟا ﺔﯿﺣﻼﺼﻟا ﺎﮭﻟ نﺄﺑ

 :ﮫﺒﺟﻮﻤﺑ ﺔﻤﻜﺤﻤﻟا
 

 ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا

 ﺔﻄﺳاﻮﺑ ،ﺮ

ﺮﻣﻷا اﺬھ ﻦ

ةءﺎﺳإ ﻦﻣ

ﮫ  ﻵﺎﺑﻲﺗ: 

ﺟﻮﻤﺑﺐ 

 ﻲﻤﺤﻣ
 

 ﻊﻨﻤﺑ

 ﺮﺧآ

 اﺬھ

ﻣﻷا

5 ﻣ
.ﺚﻟﺎﺛ فﺮط يأ ﻚﻟذ ﻲﻓ ﺎﻤﺑ ،ىﺮﺧأ

 

 ةﺮﻘﻔﻟا
 
ﻲﻓ ﻦﯿﺒﻣ ﻮھ
 اﺪﻋ ﺎﻣ
ﺎﻣ 
ﻞﺋﺎﺳو
 
لﺎﺼﺗا
 
 يأ
 وأ ﻒﺗﺎﮭﻟا
هﺎﻧدأ ﺔﻨّﯿﺒﻣ ﺮﻣﻷا
 
اﺬﮭﻟ ﺔﯿﻓﺎﺿﻹا ﺞﺋﺎﺘﻨﻟا

. 

  

__________________________________
ﺎﺗ
    
ﺮﻣﻷا لﻮﻌﻔﻣ نﺎﯾﺮﺳ ﺦﯾرﺎﺗ
____________________________________________________________________________________________________

________________________________

ﺮﻣﻷا لﻮﻌﻔﻣ ءﺎﮭﺘ

ﻧا ﺦﯾر

  _

 

 

 
 

 

 
 
 
 
 
 
 

ا اﺬ

ھ ﺔﻔ

ﺤﻣﻟﺎ

 ﺮﻣﻷ

 نﺎﯿﺼﻌﻟا

23 Pa.C.S. § 6113 
 
 ﻦﻋ ﺞﺘﻨﯾ ﺪﻗ ﺚﯿﺣ
ًﺎﻘﻓو ﺔ
 يدﺆﺗ ﺪﻗ ﺎﻤﻛ .ﺎﯿﻧﺎﻔﻠﺴﻨﺒﻟ تﺎﯾﺎﻨﺠﻟا نﻮﻧﺎﻘﻟ
 
 
ﯿﺋﺎﻨﺠﻟا
 ذﺎﻔﻧﺈﺑ ﻲﻨﻌﻤﻟا ﺐﺳﺎﻨﻤﻟا زﺎﮭﺠﻟا
 
ﻒﯾﺮﺸﻟا
 ﻰﻟإ
 ﻚﺑ ﺔﺻﺎﺨﻟا
 وأ
23 Pa C.S. 
 .
ﺔﻤﻜﺤﻤﻟ
 ا
ﻦﻣ ﺮﺧآ
ﻣأ ﺮﺮ 
ﺒﻋو
 
ضﺮ

 ﻰﻟإ يدﺆﯾ ﺪﻗ اﺬھ ﺔﻤﻜﺤﻤﻟا
ﮫﯿﻠﻋ ﺾﺒﻘﻟا
تﺎﺑﻮﻘﻌﻟاو ةﺎﺿﺎﻘﻤﻟا ﻰﻟإ ًﺎﻀﯾأ ﻚﺿﺮﻌﺗ ﺪﻗ ﺮﻣﻷا اﺬھ ﺔﻔﻟﺎﺨﻣ
. 23 Pa.C.S. §6114
 
ﺘﺳ ﻲﺘﻟ
ﻠﯾ ﻻ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
 

ا ﺐﻠﻄﺘ
 ﻻإ ﮫﻠﯾﺪﻌﺗ ﻦﻜﻤﯾ ﻻ يﺬﻟا ،ﺮﻣﻷا اﺬھ ﻲﻐ

ﻐﻟا اﺬﮭﻟ ﺔﺒﺳﺎﻨﻣ ﺔﻤﻜﺤﻣ قاروأ

ا ﺔﺤﻠﺳﻷاو ﺔﯾرﺎﻨﻟا ﺔﺤ

 ﻲﻓ ﮫﯿﻠﻋ صﻮﺼﻨﻤﻟا

ﻠﺳﻸﻟ يرﻮﻔﻟا ﻢﯿﻠﺴﺘﻟ

 ةﺮﯿﺧﺬﻟا

 ىﺮﺧﻷ

ا ﻰﻠﻋ
 

عاﺪﯾﺈﺑ

 ﻮﺤﻨﻟ

أو 

 

 

ﮫﯿﻠﻋ ﻰﻋﺪ

ﻤﻟا ﻰﻟإ رﺎﻌﺷ

إ

 
ﻚﺗزﻮﺤﺑ

،ءﺎﺴﻨﻟا ﺪﺿ ﻒﻨﻌﻟا ﺔﺤﻓﺎﻜﻣ نﻮﻧﺎﻘﻟ ًﺎﻘﻓو ﻮﻜﯾرﻮﺗ
18 U.S.C. §§2261-2262
.ةﺮﯿﺧذ وأ ﺔﯾرﺎﻧ ﺔﺤﻠﺳأ
 
ةزﺎﯿﺣ

 نﺎﻛ اذإ .
18 U.S.C. 
 

 

 ﺚﻟﻮﻨﻣﻮﻛ

و ةﺪﺤﺘﻤﻟا تﺎﯾﻻﻮ

رﻮﺑ
 
 .نﻮﻧﺎﻘﻟا ﻚﻟذ ﻰﻀﺘﻘﻤﺑ ﺔﯿﻟارﺪﻓ ﺔﯿﺋﺎﻨﺟ تاءاﺮﺟإ ﻰﻟإ ضﺮﻌﺘﺗ ﺪﻘﻓ ﺪﻤﻋ ﻦﻋ ﺮﻣﻷا اﺬھ

50
 ﺖﻔﻟﺎﺧو
اﺮﺻ ﻚﻌﻨﻤﯾ ﻻ ﺎﯿﻧﺎﻔﻠﺴﻨﺑ ﻲﻓ ردﺎﺼﻟا ﺮﻣﻷا نﺎﻛ نإو ﻰﺘﺣ ﻲﻟارﺪﻓ مﺮﺠﺑ ﻢﮭﺘﺗ ﺪﻘﻓ ،ﺮ

 ﺔﯿﻠﺒﻘﻟا ﻲﺿارﻷاو ﺎﯿﺒﻣﻮﻟﻮﻛ ﺔﻌطﺎﻘﻣو ،(

ﻢﯿﻟﺎﻗﻷاو

 ﻦﻣ ﺔﺣ

ﻠﻟ ﺔﻌ

ﺑﺎﺘﻟا

. 

18 PA.C.S. § 6105

ﺔﯾأ
 ﺐﺟﻮﻤﺑ ﺔﯾﻻﻮﻟﺎﺑ ﺔﺻﺎﺨﻟا ﺔﯿﺋﺎﻨﺠﻟا تﺎﺑﻮﻘﻌﻟاو ﺔﯿﻣاﺮﺟﻹا لﺎﻌﻓﻷا وأ

ا ،ﻚﻟ ﺔﻌﺑﺎﺘﻟا ﻦﻣﻵا ظﺎﻔﺤﻟا ﺔﺼﺧر

 ﻰ

ﻣﺘلﺎﺜ

ﻹا مﺪﻋ

ﺔﻄﺳاﻮﺑ لﺎﺼﺗﻻا

 ﺮﻣﻷ 
 
ﻲﻓ ﮫﯿﻠﻋ صﻮﺼﻨﻤﻟا ﻮﺤﻨﻟا ﻰﻠﻋ

 نﺄﺑ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا غﻼﺑإ ﮫﺒﺟﻮﻤﺑ ﻢﺘﯾ
 ﺮﺷﺎﺒﻤﻟا ﺮﯿﻏ ﻲﺋﺎﻨﺠﻟا
 ءﺎﻐﻟإ ﻰﻟإ ﺮﻣﻷا اﺬھ ﺔﻔﻟﺎﺨﻣ
ﻠﻋ ﻲﻋﺪﻤﻟا ﺔﻘﻓاﻮﻣ نإ
 .
نﻮﻧﺎﻘﻟا
. 
§6108
 
) ﻦﯿﺴﻤﺨﻟا تﺎﯾﻻﻮﻟا ﻊﯿﻤﺟ ﻲﻓ لﻮﻌﻔﻤﻟا ﺬﻓﺎﻧ ﺮﻣﻷا اﺬھ
ﺔﯾ 
18 U.S.C.  §2265
ﻣﻷا اﺬھ لﻮﻌﻔﻣ نﺎﯾﺮﺳ لﻼﺧ ةﺮﯿﺧذ
 
 وأ يرﺎﻧ حﻼﺳ
 
§922(g)(8)

ﻟإ تﺮﻓﺎﺳ اذإ .

جرﺎﺧ ﻰ

 ﻻﻮﻟا

 

   

   

 

 

 

ENGLISH/ARABIC PFA Final Order 
Pa. R.C.P 1905(e) Rev. 3-19 

                    Page 2 of 9 / 9 ﻦﻣ 

 
 2 ﺔﺤﻔﺻ 

   AOPC Rev. 4-2019 

:ﺐﺳﺎﻨﻤﻟا ﻊﺑﺮﻤﻟا ﻰﻠﻋ ﺔﻣﻼﻋ ﻊﺿ
:(ﻢھ)/ﻮھ (ﻦﯿﯿﻤﺤﻤﻟا) ﻲﻤﺤﻤﻟا (صﺎﺨﺷﻷا) ﺺﺨﺸﻟا وأ ﻲﻋﺪﻤﻟا

 

 

 

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻠﻟ (ﺔـ) ﻖﺑﺎﺳ (ﺔـ) جوز وأ (ﺔـ) جوز

 

 

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا

 ﻊﻣ

 ﻞﻔط يﻮﺑأ ﺪﺣأ

 

 

ﻲﻋﺪﻤﻟا

 ﻞﻔط

 

 

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا

 ﻞﻔط

 

ﮫﯿ 

ﻠﻋ ﻰﻋﺪﻤﻠﻟ (مﺪﻟا ﻂﺑار ) مﺪﻟﺎﺑ
 

ﺐﯾﺮﻗ ﻲﻠﺋﺎﻋ
 

دﺮﻓ

 

 

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻠﻟ ةﺮھﺎﺼﻤﻟا وأ جاوﺰﻟا
 

ﻢﻜﺤﺑ

 ﺐﯾﺮﻗ ﻲﻠﺋﺎﻋ
 

دﺮﻓ

 

 

 

  sibling (person who shares parenthood) of Defendant 

 

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻠﻟ (ةﻮﺑﻷا كرﺎﺸﯾ ﺺﺨﺷ) ﻖﯿﻘﺷ

 

 

 

 

 

 

 

    

وأ 

 

   
 

 

 هﺪﯾوﺰﺗ ﻢﺗو
. 
ىﻮﻋﺪﻟا

 
ﻢﻗر 
 
ﻼﺑإ ﻢﺗ
Pa. R.C.P.No 1930.4 
 هﺬھ نﺄﺸﺑ ﺔﻟوﺪﺠﻤﻟا عﺎﻤﺘﺳﻻا ﺔﺴﻠﺟ ﻊﻗﻮﻣو ﺦﯾرﺎﺗو ﺖﻗﻮﺑ رﺎﻌﺷﺈﺑ

ةدﺎﻤﻠﻟ ًﺎﻘﻓو ﮫﯿﻠﻋ ﻰﻋﺪ

ﻤﻟا غ

20

 نأ ﺎﻤﺑو ،
 
ﺎﻤﺑ راﺮﻗو ﻢﻜﺣو ﺮﻣأ رﺪﺻ ﺪﻘﻓ

 ،

ىﻮﻋﺪﻟا

__مﺎﻋ ﻦﻣ ،________ﺮﮭﺷ ﻦﻣ _______مﻮﯿﻟا اﺬھ ﻲﻓو ،نﻵاو
ﺘﺧا ﺎﮭﻟ ﺔﻤﻜﺤﻤﻟا
  
:ﻲﻠﯾ
اﺬھ ﻟا
 
راﺪﺻا
 ﻢﺗ
 
قﺎﻔﺗﻻﺎ
ﺑ

 هﺬھ ﻲﻓ ﻲﺋﺎﻀﻗ صﺎﺼ

تارﺎﯿﺨﻟا ﺪﺣأ

 دﺪﺣ) ﺔﻄﺳ

اﻮﺑ ﺐﻠﻄ

( 

 

فاﺮﺘﻋﻻا

 نود قﺎﻔﺗﻻﺎ
ﺑ

 

ﺔﻤﻜﺤﻤﻟا راﺮﻗو عﺎﻤﺘﺳا ﺔﺴﻠﺟ ﺪﻌﺑ

 ﺔﻣﺪﺨﻟا ﺮﯿﻓﻮﺗ ﻦﻣ ﻢﻏﺮﻟا ﻰﻠﻋ
 

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﺎﮭﯿﻟإ ﺮﻀﺤﯾ ﻢﻟ عﺎﻤﺘﺳا ﺔﺴﻠﺟ ﺪﻌﺑ

ﺔﺒﺳﺎﻨﻤﻟا

 
 ًﺎﯿﺑﺎﯿﻏ
 

. 2 (

 ًﻼﻣﺎﻛ
ﺎﺳﻹا ﻦﻣ ﺔﯾﺎﻤﺤﻟا نﻮﻧﺎﻗ ﻰﻀﺘﻘﻤﺑ
 
 

اﺬھ نﺈﻓ
 ﺐﺠﯾ
و
 ﺔﻤﻜﺤﻤﻠﻟ ﻲﺋﺎﮭﻧ ﺮﻣأ
 
.ةء 

 
 ،ﺮﻣﻷا اﺬھ راﺪﺻإ ﺔﯿﻔﯿﻛ ﻦﻋ ﺮﻈﻨﻟا ﺾﻐﺑ
ﮫﻘﯿﺒﻄﺗ
 
 ﻦﻣ ﺔﻤﻜﺤﻤﻟا ﮫﯿﻟإ ﺖﺼﻠﺧ ﺎﻣ
1 (
ةءﺎﺳﻹا
 ـﻟ حﺎﻤﺴﻠﻟ
 ﺮﯿﻓﻮﺗ ﻢﺘﯾ :ﺔﻈﺣﻼﻣ
 ﻢﺗ ﺪﻗ ﺮﻣﻷا نأ ،
 
لﺎﺜﻤﻟا ﻞﯿﺒﺳ ﻰﻠﻋ) ﺮﻣﻷا
راﺪﺻإ
 
 ﺎﮭﺒﺟﻮﻤﺑ ﻢﺗ ﻲﺘﻟا طوﺮﺸﻟا ﻦﯿﻤﻀﺗ
 ﻦﻣ ﻢﻏﺮﻟا ﻰﻠﻋ ،
 فوﺮﻈﻟا ﺔﺌﯿ
ﮭﺗ
 
ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
 نأ وأ ، فاﺮطﻷا ﺔﻘﻓاﻮﻤﺑ
 هراﺪﺻإ
 بﺎﺒﺳأ وأ ، ﺔﺴﻠﺠﻟ
ﺾﻓر
ا مﺎﻣأ لﻮﺜﻤﻟا ﻲﻓ ﻞﺸﻓ ،
ﮫﻟ ﺔﺒﺳﺎﻨﻤﻟا
 
 نﻮﻧﺎﻘﻟا ﻖﯿﺒﻄﺘﻟ ةﺪﯿﻔﻣ نﻮﻜﺗ ﺪﻗ
 تﺎﻣﻮﻠﻌﻣ
 يأ
3 (
ﯾﺎﻤﺤﻟﺎ
ﺑ
 ءﻮﺳ ﺔﺛدﺎﺣ ﻲﻓ طرﻮﺘﻣ ﺮﺧآ حﻼﺳ وأ ي
رﺎﻧ حﻼﺳ نﺎﻛ اذإ ﺎﻣ ، لﺎﺜﻤﻟا ﻞﯿﺒﺳ ﻰﻠﻋ)
 
نأ ﺪﻘﺘﻌﯾ
 
نﺎﻛ اذإ ﺎﻣ وأ ﺔﻠﻣﺎﻌﻤﻟا

ﺔﻠﻣﺎﻌﻤﻟا ءﻮﺳ ﻦﻣ ﺔ

 ﻲﻋﺪﻤﻠﻟ ﻲﺋﺎﮭﻨﻟا ﺐﻠﻄﻟا
 

.(ﺮﯿﻄﺧو ﺢﻠﺴﻣ

 ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
 

 وأ ؛ (

ﺰﯿﺣ 

 

.ﺔﯾﺎﻤﺤﻠﻟ ﻲﺋﺎﮭﻨﻟا ﺮﻣﻷا
 

راﺪﺼﺘﺳﺎﺑ
 

ﻲﻋﺪﻤﻟا

 ﺐﻠط 

ﻢﺗ ﺾﻓر

 

 

.ﺔﯾﺎﻤﺤﻠﻟ ﻲﺋﺎﮭﻨﻟا ﺮﻣﻷا
 

راﺪﺼﺘﺳﺎﺑ
 

ﻲﻋﺪﻤﻟا
 

ﺐﻠط ﻰﻠﻋ ﺔﻘﻓا

ﻮﻤﻟا

 ﺖﻤﺗ

Defendant was served, in accordance with Pa. R.C.P. No. 
1930.4 and provided notice of the time, date, and location of 
the hearing scheduled in this matter. 

AND NOW, this ____ day of __________, 20___, the court 
having jurisdiction over the parties and the subject matter, it 
is ORDERED, ADJUDGED, AND DECREED as follows: 
This order is entered by (check one) 

  By Agreement 

  By Agreement without an admission 

  After a hearing and decision by the court 

  After Hearing at which defendant was not present, despite 
proper service being made 
  By Default 

Without regard as to how this order was entered, this is a 
final order of court subject to full enforcement pursuant to 
the Protection from Abuse Act. 

ote: Space is provided to allow for 1) the court's general 

findings of abuse; 2) inclusion of the terms under which 
the order was entered (e.g., that the order was entered with 
the consent of the parties, or that Defendant, though 
properly served, failed to appear for the hearing, or the 
reasons why the plaintiff's request for a final PFA order 
was denied); or 3) information that may be helpful to law 
enforcement (e.g., whether a firearm or other weapon was 
involved in the incident of abuse or whether Defendant is 
believed to be armed and dangerous). 

Plaintiff's request for a final protection order is denied. 

Plaintiff's request for a final protection order is granted. 

  N

R 

 

  O

 

   

ENGLISH/ARABIC PFA Final Order 
Pa. R.C.P 1905(e) Rev. 3-19 

                    Page 3 of 9 / 9 ﻦﻣ 

 
 3 ﺔﺤﻔﺻ 

   AOPC Rev. 4-2019 

  child of Plaintiff 

  child of Defendant 

  family member related by blood (consanguinity) to  
      Defendant 

  family member related by marriage or affinity to  

            Defendant 
 

  spouse or former spouse of Defendant 

  parent of a child with Defendant 

 

CHECK ALL THAT APPLY: 
Plaintiff or Protected Person(s) is/are: 

 

 

 

  current or former sexual or intimate partner with Defendant 

 

 ﮫﯿﻠﻋ
 

ﻰﻋﺪﻤﻟا ﻊﻣ

 (ﺔـ) ﻖﺑﺎﺳ وأ (ﺔـ) ﻲﻟﺎﺣ ﻢﯿﻤﺣ وا ﻲﺴﻨﺟ (ﺔـ) ﻚﯾﺮﺷ

 

FINAL PROTECTION FROM ABUSE ORDER  
ةءﺎﺳإ ﻦﻣ ﺔﯾﺎﻤﺤﻠﻟ ﻲﺋﺎﮭﻨﻟا ﺮﻣﻷا  
 

 1. Defendant shall not abuse, stalk, harass, threaten, or 

attempt or threaten to use physical force against Plaintiff 
or any other protected person in any place where they 
might be found. 
 

 2. Defendant is completely evicted and excluded from the 

 residence at  
_______________________________________________ 

(Non-confidential address from which Defendant is excluded) 

_______________________________________________ 

 ﺔﻟوﺎﺤﻣ وأ ﺪﯾﺪﮭﺘﻟا وأ ﺔﻘﯾﺎﻀﻤﻟا وأ ﺐّﻘﻌﺘﻟا وأ ةءﺎﺳﻹا ﻦﻣ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻊﻨﻤُﯾ
 ﻲﻤﺤﻣ
 
ﺑ ﺪﯾﺪﮭﺘﻟا وأ
ﺪﺟاﻮﺘﯾ ﺪﻗ نﺎﻜﻣ يأ ﻲﻓ

ﺺﺨﺷ يأ وأ
 

 
ﺔﯾﺪﺴﺠﻟا ةﻮﻘﻟا

ﻲﻋﺪﻤﻟا ﺪﺿ

 ماﺪﺨﺘﺳﺎ

 ﺮﺧآ

نو 

.ﮫﯿﻓ

 

 1. 

 

 
 2 .
  
_______________________________________________

اﻮﻟا ﻦﻜﺴﻤﻟا ﻦﻣ ًﺎﯿﻠﻛ هدﺎﻌﺑإو ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا دﺮط ﻢﺘﯾ

 ﻲﻓ ﻊﻗ

 

 

 

 

_______________________________________________

 
(
ﻰﻋﺪﻤﻟا ﮫﻨﻣ دوﺮﻄﻤﻟا يﺮﺴﻟا ﺮﯿﻏ ناﻮﻨﻌﻟا)
 
ﻋ
ﯿ
ﻠ
ﮫ

   

or any other residence where Plaintiff or any other person 
protected under this order may live. Exclusive possession 
of the residence is granted to Plaintiff. Defendant shall 
have no right or privilege to enter or be present on the 
premises of Plaintiff or any other person protected under 
this order. 
 

 On  

 اﺬھ ﺐﺟﻮﻤﺑ ﻲﻤﺤﻣ ﺮﺧآ ﺺﺨﺷ يأ وأ ﻲﻋﺪﻤﻟا ﮫﯿﻓ ﺶﯿﻌﯾ ﺪﻗ

 يأ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ىﺪﻟ ﺲﯿﻟ .ﻲﻋﺪﻤﻠﻟ ﺢﻨﻤُﺗ
 

 يأ وأ ﻲﻋﺪﻤﻟا
 

ﺔﻣﺎﻗإ ﻦﻛﺎﻣأ

 ﺮﺧآ

 ﻦﻜﺴﻣ يأ وأ
 ﺔﯾﺮﺼﺤﻟا ةزﺎﯿﺤﻟا .ﺮﻣﻷا
 ﻲﻓ ًاﺮﺿﺎﺣ نﻮﻜﯾ نأ وأ لﻮﺧﺪﻟ زﺎﯿﺘﻣا وأ ﻖﺣ
.ﺮﻣﻷا اﺬھ ﺐﺟﻮﻤﺑ ﻲﻤﺤﻣ ﺮﺧآ ﺺﺨﺷ

ﻦﻜﺴﻤﻠﻟ

 

ﺦ  

 
ﯾرﺎﺘﺑ

 

_______________________________________________ 
(Date and time) 

 

_______________________________________________ 
 
)
ﻟ
ا
ﺘ
ﺎ
ر
ﯾ
ﺦ
 
و
ﻟ
ا
ﻮ
ﻗ
ﺖ
(

 

Defendant may enter the residence to retrieve his/her 
clothing and other personal effects, provided that 
Defendant is in the company of a law enforcement 
officer or sheriff when such retrieval is made and 
(insert any other conditions): ___________________ 
___________________________________________ 

 
 ﺔﯿﺼﺨﺸﻟا ﮫﺗﺎﺟﺎﺣو ﮫﺴﺑﻼﻣ جاﺮﺨﺘﺳﻻ ﻦﻜﺴﻤﻟا لﻮﺧد ﮫﯿﻠﻋ ﻰﻋﺪﻤﻠﻟ ﻦﻜﻤﯾ
 ﺪﻨﻋ
 وأ ﻲطﺮﺷ ﺔﺒﺤﺼﺑ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا نﻮﻜﯾ نأ ﺔﻄﯾﺮﺷ ،ىﺮﺧﻷا
 
_____________________________________
 
.ﻚﻟﺬﺑ مﺎﯿﻘﻟا
_ 
___________________________
________________

ﻒﯾﺮﺸﻟا

 

 

 3. Except as provided in Paragraph 5 of this order, 
Defendant is prohibited from having ANY CONTACT 
with Plaintiff, either directly or indirectly, or any other 
person protected under this order, at any location, 
including but not limited to any contact at Plaintiff's 
school, business, or place of employment. Defendant is 
specifically ordered to stay away from the following 
locations for the duration of this order. 

______________________________________________ 
______________________________________________ 
______________________________________________ 

 ﻰﻋﺪﻤﻟا

 نﺈﻓ

 ،ﺮﻣﻷا اﺬھ ﻦﻣ

 يﺄﺑ وأ ،ﺮﺷﺎﺒﻣ ﺮﯿﻏ وأ ﺮﺷﺎﺒﻣ ﻞﻜ
 ﻞﯿﺒﺳ ﻰﻠﻋ
 
ﻚﻟذ ﻲﻓ ﺎﻤ
 
.ﮫﺘﻔﯿظو نﺎﻜﻣ وأ ﮫﻠﻤﻋ وأ ﻲﻋﺪﻤﻟا ﺔﺳرﺪﻤ

لﺎﺼﺗا يأ

صﻮﺼﻨﻣ ﻮھ

ﮫﯿﻠﻋ 
 
 ﻢﻗر5 
 
ةﺮﻘﻓ
 ﻲﻓ
ﺎﻣ 
 ﺸﺑ
 ،ﻲﻋﺪﻤﻟﺎﺑ
 
 ﻦﻣ عﻮﻨﻤﻣ ﮫﯿﻠﻋ
ﺑ ،ﻊﻗﻮﻣ يأ ﻲﻓ ﺮﻣﻷا اﺬھ ﺐﺟﻮﻤﺑ ﻲﻤﺤﻣ ﺮﺧآ ﺺﺨﺷ
ﺑ لﺎﺼﺗا يأ ﺮﺼﺤﻟا ﺲﯿﻟو لﺎﺜﻤﻟا
 ﺮﻣﺆ
 ُﯾ
:ﺮﻣﻷا اﺬھ لﻮﻌﻔﻣ نﺎﯾﺮﺳ

 

 ﺔﻠﯿط ﺔﯿﻟﺎﺘﻟا ﻊﻗاﻮﻤﻟا ﻦﻋ ًاﺪﯿﻌﺑ ﻰﻘﺒﯾ نأ صﺎﺧ ﻞﻜﺸﺑ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا

 اﺪﻋ ﺎﻣ .

 3

 

 

      _________________________________________________ 
__________________________________________________ 
____________________________________________________
___________________________________________ 

 4. Except as provided in Paragraph 5 of this order, 
Defendant shall not contact Plaintiff, either directly or 
indirectly, or any other person protected under this order, 
by telephone or by any other means, including through 
third persons. 

 

 نﺈﻓ
،ﺮﻣﻷا اﺬھ ﻦﻣ
 ﻢﻗر5 
 
 ﺮﯿﻏ وأ ﺮﺷﺎﺒﻣ ﻞﻜﺸﺑ ءاﻮﺳ
 ﺔﻄﺳاﻮﺑ ﺮﻣﻷا اﺬھ ﺐﺟﻮﻤﺑ ﻲﻤﺤﻣ ﺮﺧآ ﺺﺨﺷ يﺄﺑ وأ

 ﻲﻓ ﮫﯿﻠﻋ صﻮﺼﻨﻣ ﻮھ ﺎﻣ اﺪﻋ ﺎﻣ
ةﺮﻘﻓ
 ،ﻲﻋﺪﻤﻟﺎﺑ لﺎﺼﺗﻻا ﻦﻣ عﻮﻨﻤﻣ ﮫﯿﻠﻋ
ﺮﺷﺎﺒﻣ
ﺔﻠﯿﺳو يأ وأ ﻒﺗﺎﮭﻟا

 ﺮﺒﻋ ﻚﻟذ ﻲﻓ ﺎﻤﺑ ىﺮﺧأ

فاﺮطأ

 
لﺎﺼﺗا

 ،

 

ﺜﻟﺎﺛﺔ . 
 

 4. 

 
 ﻰﻋﺪﻤﻟا

 5. Temporary custody of the minor children, [NAMES 
OF THE CHILDREN SUBJECT TO THE PROVISION 
OF THIS PARAGRAPH]    
________________________________________________
________________________________________________
________________________________________________ 
       
shall be as follows: 

 
 5
 
ةﺮﻘﻔﻟا هﺬھ

ا ﺔﻧﺎﻀﺤﻟا .
( 

 مﺎﻜﺣﻷ ﻦﯿﻌﺿﺎﺨﻟا

 لﺎﻔطﻷا

 ءﺎﻤﺳأ

) ،ﻦﯾﺮﺻﺎﻘﻟا لﺎﻔطﻸﻟ ﺔﺘﻗﺆﻤﻟ

 
 
 

_____________________________________________
_____________________________________________
_____________________________________________
 

      
:ﻲﻠﯾ ﺎﻤﻛ نﻮﻜﺘﺳ

 

 

 

 

 

           

           

ENGLISH/ARABIC  PFA Final Order                                                             Page 4 of 9 / 9 ﻦﻣ 
Pa. R.C.P 1905(e) Rev. 3-19 

 4 ﺔﺤﻔﺻ 

 

                      AOPC Rev. 4-2019 

 

   

 

 

 

 

: 

ﺐﺳﺎﻨﻤﻟا

 ﻊﺑﺮﻤﻟا ﻰﻠ

ﻋ

 ﺔﻣﻼﻋ ﻊﺿ
 
 

 

 اذإ ، ةرﺎﯾﺰ

 ﻖﺣﻟا

 وأ ﺔﯿﺋﺰﺠﻟا ﺔﻧﺎﻀﺤﻟا دﻮﻨﺑ جردأ ؛ﺔﯿﺴﯿﺋﺮﻟا ﺔﻧﺎﻀﺤﻟا
 

       ___________________________________________
)
 ﻦَﻤﻟ ﺮﻛذا
  
(تﺪﺟ ُو
_____________________________________________
_____________________________________________
_____________________________________________

 ﺖﺤﻨﻣ

 
 
 

 

.ﻦﯿﻋزﺎﻨﺘﻤﻟا ﻦﯿﻓﺮﻄﻟا لﺎﻔطﻷ ﺔﺒﺴﻨﻟﺎﺑ
 

 
__________________________________________________ 

ﻲﻟﺎﺣ ﺔﻧﺎﻀﺣ
 

 كﺎﻨھ
 

ﺮﻣأ

__________________________________________________ 

(ﺔﯿﻀﻘﻟا ﻢﻗرو ﺔﻌطﺎﻘﻤﻟا ﺔﻤﻜﺤﻣ) 

ﻖﻟﺎﻋ 
ﺔ 
ﻟوﺪﺠﻣ

 
   
 ﺔﻧﺎﻀﺤﻟا سﺎﻤﺘﻟا
    
 عﺎﻤﺘﺳﻻا ﺔﺴﻠﺟ

 

:ﻲﻓ

____________________________________________ 
ﻜﻤﻟاو ﺖﻗﻮﻟاو ﺦﯾرﺎﺘﻟا) 
ﺎ
ن
(

 

ﻲﻟﺎﺤﻟا ﺔﻧﺎﻀﺤﻟا

 

ﺮﻣأ

 ﻞﻄﺒﯾ ﻻ ﺮﻣﻷا اﺬھ

 

 

 

لﺎﻔطأ

 ﺔﻧﺎﻀﺤﻟ ﺔﺒﺴﻨﻟﺎﺑ ﻖﺑﺎﺳ
 

ﺮﻣأ

 يأ ﻞﻄﺒﯾ ﺮﻣﻷا اﺬھ

 

 

5 

 ةﺮﻘﻔﻟا ﻲﻓ ةدراﻮﻟا ﺔﯾﺎﺻﻮﻟا  مﺎﻜﺣأ

 
 ﺮﻣﻷا اﺬھ ﻦﻣ
 نإ
 ﺎًﻘﻓو  ﺔﻧﺎﻀﺤﻟا  تاءاﺮﺟإ  ءﺪﺑ  ﻦﯿﻓﺮﻄﻟا  ﻦﻣ  يﻷ  زﻮﺠﯾ
ﺔﺘﻗﺆﻣ
( 
ءﺎﺴﻣ
 ﺔﻋﺎﺴﻟا ﻲﻓ ﺔﻧﺎﻀﺤﻟا نﻮﻧﺎﻘﻟ
 
 ﻦﻣ ﻲﺋﺎﮭﻨﻟا ﺔﯾﺎﻤﺤﻟا ﺮﻣأ ﺪﻌﺑ ﮫﻟﺎﺧدإ ﻢﺘﯾ ﺔﻧﺎﻀﺤﻠﻟ ﺢﻟﺎﺻ ﺮﻣأ يأ ﻞﺤﯾ
ﻷا اﺬھ ﻲﻓ ةدراﻮﻟا ﺔﻧﺎﻀﺤﻟا مﺎﻜﺣأ ﻞﺤﻣ ةءﺎﺳﻹا

Pa.C.S.  §§  5321—  5340

  ﺚﯿﺣ

.ﺮﻣ 

11 

 )

 

 

 ةﺮﯿﺧﺬﻟا

أو 

 ىﺮﺧأ ﺔﺤﻠﺳﻷاو ﺔﯾرﺎﻨ
ﻟا

 ﺔﺤﻠﺳﻷا دﻮﯿﻗ

 6 .

 

 

 
:ﺐﺳﺎﻨﻤﻟا ﻊﺑﺮﻤﻟا ﻰﻠﻋ ﺔﻣﻼﻋ ﻊﺿ

 

 
 وأ ﻞﻘﻧ وأ كﻼﺘﻣا ﻦﻣ عﻮﻨﻤﻣ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
ﺮﻣﻷا اﺬھ لﻮﻌﻔﻣ

. 

 

 
 
ﺎﮭﻜﻠﻤﯾ ﻲﺘﻟا ﺔﯿﻟﺎﺘﻟا ﺔﯾرﺎﻨﻟا ﺔﺤﻠﺳﻷا ﺺَﺧ ُر
 

 
 
 ﻢﯿﻠﺴﺗ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻰﻠﻋ
ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
_____________________________________________ 

 
ﻒﯾﺮﺸﻟا
.ﮫﺗزﻮﺤﺑ ةدﻮﺟﻮﻤﻟ

 أوا

_____________________________________________ 

_____________________________________________ 

 ﻲﻨﻌﻤﻟا ﺐﺳﺎﻨﻤﻟا زﺎﮭﺠﻟا

ﻒﯾﺮﺸﻟا
 ﻖﺤﻠﻣ ﻲﻓ ةرﻮﻛﺬﻣ ةﺮﯿﺧذ وأ ىﺮﺧ

 وأ
 

 
 
 ﻢﯿﻠﺴﺘﺑ مﻮﻘﯾ نﺄ
ﺑ
 ﮫﯿﻠﻋ ﻰﻋﺪﻤﻠﻟ
 
ﺮﻣأ رﺪﺼﯾ
أ ﺔﺤﻠﺳأ وأ ﺔﯾ
رﺎﻧ ﺔﺤﻠﺳأ يأ
 
نﻮﻧﺎﻘﻟا ذﺎﻔﻧﺈﺑ
 
 .ةرﺎﺷﻹﺎﺑ ﺎﻨھ جرﺪﻤﻟا ،
أ ﺖﻗﺆﻤﻟا ﺮﻣﻷ
ا

  _

 

 

     

Check all that apply: 
 

_____________________________________________ 
(State to whom primary physical custody is awarded; state terms of 
partial custody or visitation, if any) 
_____________________________________________ 
_____________________________________________ 
_____________________________________________ 

 There is a current custody order as to the  

                   children of the parties: 

__________________________________________________ 

__________________________________________________ 
(County Court and docket number) 

 A custody petition is pending. 
 A hearing is scheduled for 

___________________________________________ 

(Date, time and location) 

 THIS ORDER SHALL NOT SUPERSEDE THE 

CURRENT CUSTODY ORDER 

 THIS ORDER SUPERSEDES ANY PRIOR 
ORDER RELATING TO CHILD CUSTODY 

he custody provisions of Paragraph 5 of this order 

are temporary. Either party may initiate custody 
proceedings pursuant to the custody statute at 23 
Pa.C.S. §§ 5321— 5340. Any valid custody order 
entered after the final Protection From Abuse order 
supersedes the custody provisions of this order. 

 
 6. FIREARMS, OTHER WEAPONS, OR AMMUNITION 

 Defendant shall relinquish to the sheriff or the 

appropriate law enforcement agency the following firearm 
licenses owned or possessed by Defendant: 
_____________________________________________ 

_____________________________________________ 

_____________________________________________ 

 Defendant is directed to relinquish to the sheriff or the 
appropriate law enforcement agency any firearm, other 
weapon, or ammunition listed in Attachment A to the 
Final Order, which is incorporated herein by reference. 

RESTRICTIONS 

heck all that apply: 

  C

 

 

 

  T

 

  D

 

   

 

 

 

 Defendant is prohibited from possessing or acquiring 

 نﺎﯾﺮﺳ لاﻮط ﺔﯾرﺎﻧ ﺔﺤﻠﺳأ يأ

 

ةزﺎﯿﺣ

any firearms for the duration of this order. 

efendant may relinquish any firearms, other weapons, or 
ammunition to the sheriff or the appropriate law enforcement 
agency. As an alternative, Defendant may either relinquish 
firearms, other weapons, or ammunition to a third party 
provided Defendant and the third party first comply with all 
the requirements to obtain a safekeeping permit, or 
relinquish firearms, other weapons, or ammunition to a 

 

ﻒﯾﺮﺸﻟا

 ﻰﻟإ ةﺮﯿﺧذ وأ ىﺮﺧأ ﺔﺤﻠﺳأ وأ ﺔﯾرﺎﻧ ﺔﺤﻠﺳأ يأ ﻢﯿﻠﺴﺗ

 ﻰﻋﺪﻤﻠ
 ﻦﻜﻤﯾ ،ﻚﻟﺬﻟ ﻞﯾﺪﺒﻛو
 .
نﻮﻧﺎﻘﻟا ذﺎﻔﻧﺈﺑ ﻲﻨﻌﻤﻟا ﺐﺳﺎﻨﻤﻟا زﺎﮭﺠﻟا
 ﺎﻣإ ﮫﯿﻠﻋ
ﻟ
 نأ ﺔﻄﯾﺮﺷ ﺚﻟﺎﺛ فﺮط ﻰﻟإ
ىﺮﺧأ ﺔﺤﻠﺳأ
 
ةﺮﯿﺧذ وأ
 
 
ﺑ ًﻻوأ ﺚﻟﺎﺜﻟا فﺮﻄﻟاو
 ﺔﺼﺧر ﻰﻠﻋ لﻮﺼﺤﻠﻟ تﺎﺒﻠﻄﺘﻤﻟا ﺔﻓﺎﻜ
 ﻢﯿﻠﺴﺗ وأ
 
ﺔﯾرﺎﻧ
 

 ﮫﯿﻠﻋ ﻰﻋﺪﻤﻠﻟ ﻦﻜﻤﯾ
 وأ
ﺔﯾرﺎﻨﻟا ﺔﺤﻠﺳﻷا
 ﻢﯿﻠﺴﺗ
ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
 
ﺪﯿﻘﺘﯾ
دﺪﺼﻟا اﺬھ ﻲﻓ ﻦﻣﻵا ظﺎﻔﺤﻟا
ﺔﺤﻠﺳأ ﺮﺟﺎﺗ ﻰﻟإ ةﺮﯿﺧﺬﻟا

أو 
 ﻞﻜﺸﺑ ﺎﮭﺘﯿﻜﻠﻣ ﻞﻘﻧ وأ ﺔﻟﻮﻤﻌﺑ ﺎﮭﻌﯿﺒﻟ

 ىﺮﺧﻷا ﺔﺤﻠﺳﻷاو ﺔﯾرﺎﻨﻟا ﺔﺤﻠﺳﻷا

 ﺺﺧﺮﻣ

 يأ وأ

 

 

ENGLISH/ARABIC  PFA Final Order                                                             Page 5 of 9 / 9 ﻦﻣ 
Pa. R.C.P 1905(e) Rev. 3-19 

 5 ﺔﺤﻔﺻ 

 

                      AOPC Rev. 4-2019 

ً
licensed firearms dealer for consignment sale, lawful 
transfer, or safekeeping pursuant to 23 Pa. C.S. §6108.2(e). 
Defendant must relinquish any firearm, other weapon, 
ammunition, or firearm license ordered to be relinquished no 
later than 24 hours after service of this order. Failure to 
timely relinquish any firearm, other weapon, ammunition, or 
any firearm license ordered to be relinquished shall result in 
a violation of this order and may result in criminal conviction 
under the Uniform Firearms Act, 18 Pa. C.S. §6105. 

 يأ وأ يرﺎﻧ ح
 لﻼﺧ ﺮﻣﻷا اﺬھ ﺐﺟﻮﻤﺑ
 

 ﺳﻼ

يأ

 ﻢﯿﻠﺴﺗ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻰﻠﻋ ﺐﺠﯾ
. 

يرﺎﻧ حﻼﺳ ةزﺎﯿﺤ

 حﻼﺳ يأ ﻢﯿﻠﺴﺘﺑ
 مﺎﯿﻘﻟا مﺪﻋ نإ .ﺮﻣﻷا اﺬﮭﺑ ﮫﻏﻼﺑإ ﺪﻌﺑ ﺔﻋﺎﺳ
يرﺎﻧ حﻼﺳ ةزﺎﯿﺤ
 ﺖﻗﻮﻟا ﻲﻓ
 
ﻟ
 ﺔﺼﺧر يأ وأ ةﺮﯿﺧذ وأ ﺮﺧآ
 نﻮﻧﺎﻗ ﻰﻀﺘﻘﻤﺑ ﺔﯿﺋﺎﻨﺟ ﺔﻧادإ ﮫﻨﻋ ﻢﺠﻨﯾ

 وﺪﻗ 
18 Pa.C.S. §6105

. 

 

ةدﺎﻤﻠﻟ ًﺎﻘﻓو نﺎﻣﺄﺑ ﺎﮭﻈﻔﺣ وأ ﻲ

ﻧﻮﻧﺎﻗ
23 Pa. C.S. §6108.2(e)
 ﺔﺼﺧر يأ وأ ةﺮﯿﺧذ وأ ﺮﺧآ حﻼﺳ
ﻟ
24 
 زوﺎﺠﺘﺗ ﻻ ةﺪﻣ
 حﻼﺳ يأ وأ يرﺎﻧ
ﺮﻣﻷا اﺬھ ﺔﻔﻟﺎﺨﻣ ﻰﻟإ يدﺆﯾ دﺪﺤﻤﻟا
،ﺪﺣﻮﻤﻟا ﺔﯾرﺎﻨﻟا ﺔﺤﻠﺳﻷا

 

  

 

 وأ
 

ﻒﯾﺮﺸﻟا

نﻮﻧﺎﻘﻟا ذﺎﻔﻧﺈﺑ ﻲﻨﻌﻤﻟا ﺐﺳﺎﻨﻤﻟا زﺎﮭﺠﻟا
 تﺎﺒﻠﻄﺘﻤﻟا ﻲﻓﻮﺘﺴﯾ ﻞھﺆﻣ ﺚﻟﺎﺛ فﺮط وأ
 
23 Pa C.S.  
 ﻰﻟإ

 7إ .
 وأ
 ـﻟ ًﺎﻘﻓو ةردﺎﺻ ﻦﻣآ ظﺎﻔﺣ ﺔﺼﺧر ﻰﻠﻋ لﻮﺼﺤﻠﻟ ﺔﯿﺳﺎﺳﻷاو ﺔﯿﺋاﺮﺟﻹا
§6108.3
ﺪﺼﯾ ن
أ

 يرﺎﻧ حﻼﺳ يأ ن
 ﻰﻟإ
 
ﺺﺧﺮﻣ
 ﺔﯾرﺎﻧ ﺔﺤﻠﺳأ ﺮﺟﺎﺗ ﻰﻟإ ﮫﻠﻘﻧ ﻢﺘﯾ

دﺎﻌﯾ ﻻ
.نﻮﻧﺎﻘﻟا ﮫﯿﻠﻋ ﺺﻨﯾ ﺎﻤﻛ ىﺮﺧأ ﺔ

 
ﻮﻤﺑ وأ ﺮﻣﻷا اﺬھ ﺐﺟﻮﻤﺑ
ﺮﻣأ ر

ﻘﯾﺮﻄﺑ وأ ﺔﻤﻜﺤﻤﻟا ﻦﻣ ﺮﺧآ
 

 ﺖﻗﺆﻤﻟا ﺮﻣﻷا ﺐﺟ

 ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻰﻟإ
 

ﮫﻤﯿﻠﺴﺗ ﻢﺘﯾ

 

 

 ﻰﻟإ ﻲﻋﺪﻤﻟا ﺔﻘﻓاﺮﻣ
سﺎﻤﺘﻟﻻا ﻢﯾ

 وأ
 

 

ﻒﯾﺮﺸﻟا

 وأ ﺔﯾﺪﻠﺒﻟا ﺔطﺮﺸﻟا وأ ﺎﯿﻧﺎﻔﻠﺴﻨﺑ ﺔﯾﻻو ﺔطﺮﺷ
ﺪﻘﺗ ءﺎﻨﺛأ ﻲﻋﺪﻤﻟا ﺔﻘﻓاﺮﻤﻟ وأ ﺔﯿﺼﺨﺸﻟا ﻢﮭﺗﺎﻘﻠﻌﺘﻣ ةدﺎﻌﺘﺳﻻ ﮫﺘﻣﺎﻗإ ﻞﺤﻣ
 ﺪﺿ ﺮﻣﻷا

ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا

 ﻰﻠﻋ ﺐ

. 

 8 .ﺠﯾ

 

: 
نﻮﻧﺎ

ﻘﻟا

 ﻦﻣ

 
§6108

 

ةدﺎﻤﻟا هﺰﯿﺠﺗ ﺎﻤﻛ

 

ﻲﻟﺎﺘﻟا ﻲﻓﺎﺿﻹا

 

فﺎﺼﻧﻹا
 

ﺢﻨﻤﯾ

 9 .

 

      ________________________________________________
________________________________________________
________________________________________________

 
 

 
 7. Any firearm delivered to the sheriff or the appropriate 
law enforcement agency or transferred to a licensed 
firearm dealer or a qualified third party, who satisfies the 
procedural and substantive requirements to obtain a 
safekeeping permit issued under 23 Pa C.S.  §6108.3 
pursuant to this order or the temporary order, shall not be 
returned to Defendant until further order of court or as 
otherwise provided by law. 

 
 8. The Pennsylvania State Police, the municipal police, or 

the sheriff shall accompany Plaintiff to his or her 
residence to retrieve personal belongings. 

 9. The following additional relief is granted as authorized 

by §6108 of the Act: 
__________________________________________________ 
__________________________________________________ 
__________________________________________________ 

 

 Defendant is prohibited from stalking, as 
defined in 18 Pa. C.S. §2709.1, or harassing, as 
defined in 18 Pa. C.S. §2709, the following family  
and household members of Plaintiff: 

Name / ﻢﺳﻻا 

Address / ناﻮﻨﻌﻟا 

18 

 18 

ةدﺎﻤﻟا ﻲﻓ ف ّﺮﻌﻣ ﻮھ ﺎﻤﻛ ،ﺐّﻘﻌﺘ
 
 ﻦﻣ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻊﻨﻤُﯾ
ﻟا
Pa.C.S.§2709
 ف ّﺮﻌﻣ ﻮھ ﺎﻤﻛ ،
ﺔﻘﯾﺎﻀﻤﻟا
 وأ ،
Pa.C.S.§2709
 ،

ﻲﻋﺪﻤﻟا لﺰﻨﻣو ﺔﻠﺋﺎﻋ داﺮﻓأ

:ﻦﯿﯿﻟﺎﺘﻟا
 

 ةدﺎﻤﻟا ﻲﻓ
 

 

Relationship to Plaintiff / 
ﻲﻋﺪﻤﻟﺎﺑ ﺔﻗﻼﻌﻟا 

 
 
 

 
 
 

 Other relief:  
_________________________________________ 
_________________________________________ 

 
____________________________________________
____________________________________________

 
ﺮﺧآ فﺎﺼﻧإ

: 

 
 10. Defendant is directed to pay temporary support for:  

_____________________________________________ 
_____________________________________________ 

(Names of the persons for whom support is to be paid) 

as follows: 
_____________________________________________ 
_____________________________________________ 
_____________________________________________ 
(Amount, frequency and other terms and conditions of the Support Order) 

 

:ـﻟ ﺔﺘ

ﻗﺆﻣ ﺔﯿﻟﺎﻣ ﺔﻧﺎﻋﺈ
 ﺑ

ﺪﯾوﺰﺘﻟﺎﺑ

 ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﺮﻣﺆﯾ .

 10

 

_____________________________________________ 
_____________________________________________ 
ﺨﺷﻷا ءﺎﻤﺳأ)
ﺗﻢﮭﻠ ﺔﻘﻔﻧ( 
ﺪ
 
ﻓ
ﻌ
ﺎ
ص
ا
 
ﻟ
ﺬ
ﯾ
ﻦ
:ﻲﻟﺎﺘﻟا ﻮﺤﻨﻟا ﻰﻠﻋ
 
______________________________________________
_____________________________________________ 
_____________________________________________ 
ا( 
 
ﻟ
ﻨ
ﻔ
ﻘ
ﺔ
ﺮﻣﻷ ىﺮﺧأ طوﺮﺷو دﻮﻨﺑو راﺮﻜﺘﻟا ،ﻎﻠﺒﻤﻟا)

 

Domestic Relations 

ﺔﻘﻔﻨﻟا
ه 
ﺬھ ﺔﻄﺳاﻮﺑ ﻲﺋﺎﮭﻨﻟا ﺮﻣﻷا رﺪﺼﯾ ﻰﺘﺣ لﻮﻌﻔﻤﻟا يرﺎﺳ اﺬھ
 
 ﺮﻣأ ﻰﻘﺒﯿﺳ
ﻤﻟا ﻊﻓﺮﯾ ﻢﻟ لﺎﺣ ﻲﻓ ﺎﯿﺋﺎﻘﻠﺗ ﻲﮭﺘﻨﯾ ﺮﻣﻷا اﺬھ
 ﻦﻣ ىﻮﻜﺷ ﻲﻋﺪ
 
 نأ
ﻻإ .ﺔﻤﻜﺤﻤﻟا
 ﻞﺟأ
ﯾ) ﺔ
ﺮﺳﻷا تﺎﻗﻼﻌﻟا ﻢﺴﻗ ىﺪﻟ
 
ﺔﻘﻔﻨﻟا
Section
 ﺲﻜﻌﯾ ﻻ .ﺮﻣﻷا اﺬھ راﺪﺻإ ﺦﯾرﺎﺗ ﻦﻣ ﻦﯿﻋﻮﺒﺳأ لﻼﺧ ﺔﻤﻜﺤﻤﻠﻟ (
اﺬھ هﺮﻘﯾ يﺬﻟا
 
ﻎﻠﺒﻤ
ﻟا
ﻤﺘﺳﻻا ﺔﺴﻠﺟ تادﺎﺷرﻹ ًﺎﻘﻓو ﺎھﺪﯾﺪﺤﺗ ﻢﺘﯿﺳ ﻲﺘﻟاو ،ﮫﯿﻠﻋ ﻰﻋﺪﻤﻠﻟ
 تﻼﯾﺪﻌﺗ ﺔﯾأ
 ﻞﺠﺴﺘﺳ
ﻟا ﻎﻠ
 لوﺎﻨﺘﺗ
.ﺐﺳﺎﻨﻤﻟا فﺮﻄﻟا بﺎﺴﺤﻟ ،ﺦﯾرﺎﺘﻟا اﺬھ ﻰﺘﺣ

 ﺔﺤﯿﺤﺼﻟا ﻢﻋﺪﻟا تﺎﻣاﺰﺘﻟا ةروﺮﻀﻟﺎﺑ ﺖﻗﺆﻤﻟا ﺮﻣﻷا

 ﻲﺘﻟا عﺎ
 ﺮﺛﺄﺑ

ﺒ
ﻤﻟا ﻰﻠﻋ

 ﻲﻌﺟر

ﺎﮭﻨ
 

 ﺔﻘﻔﻨﻠﻟ

ﺔﻘﻔﻨﻟا

 ﻲﺋ

 نإ

 .

 

   

 

his order for support shall remain in effect until a final 

support order is entered by this court.  However, this 
order shall lapse automatically if Plaintiff does not file a 
complaint for support with the Domestic Relations 
Section of the court within two weeks of the date of this 
order.  The amount of this temporary order does not 
necessarily reflect Defendant's correct support obligation, 
which shall be determined in accordance with the 
guidelines at the support hearing.  Any adjustments in the 
final amount of support shall be credited, retroactive to 
this date, to the appropriate party. 

 

    T

ENGLISH/ARABIC  PFA Final Order                                                             Page 6 of 9 / 9 ﻦﻣ 
Pa. R.C.P 1905(e) Rev. 3-19 

 6 ﺔﺤﻔﺻ 

 

                      AOPC Rev. 4-2019 

   

 

 

 

 
 
 

 
 
 

 

 

 11.   (a) The costs of this action are imposed on 

 

.ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا
 

ىﻮﻋﺪﻟا

ه 

ﺬھ ﻒﯿﻟﺎﻜﺗ ﻞﻤﺤﺘﯾ (أ)

 

 11.  

 

 (b) Because this order followed a contested 

proceeding, or a hearing at which the Defendant was not 
present, despite being served with a copy of the petition, 
temporary order and notice of the date, time and place of 
the hearing, Defendant is ordered to pay an additional 
$100 surcharge to the court, which shall be distributed in 
the manner set forth in 23 Pa. C.S. §6106(d).  

ﻧ ﮫﻤﯿﻠ

 ﻊﺒﺗ
 
ﯿﻓ ًاﺮﺿﺎ

ﺮﻣﻷا اﺬھ نأ ﺎﻤﺑ (

ﺳا ﺔﺴﻠﺟ وأ ،ﺎﮭﺑ نﻮﻌﻄﻣ ىﻮﻋد
 ﻦﻋ ﺔﺨﺴ
ﺴﺗ ﻦﻣ ﻢﻏﺮﻟﺎﺑ ،ﺎﮭ

 
ﻋ ﻰﻋﺪﻤﻟا ﻦﻜﯾ ﻢﻟ
 ﺔﺴﻠﺟ نﺎﻜﻣو ﺖﻗوو ﺦﯾرﺎﺘﺑ رﺎﻌﺷإو ةءﺎﺳإ ﻦﻣ ﺔﯾﺎﻤﺤﻟا سﺎﻤﺘﻟا
 
ﻲﻓﺎﺿإ
 ﻎﻠﺒﻣ ﻊﻓﺪﺑ
هرﺪﻗ
ﻠﻋ ﻰﻋﺪﻤﻟا ﺔﻤﻜﺤﻤﻟا ﺮﻣﺄﺗ ،عﺎﻤﺘﺳﻻا
 
 100 
 
ﮫﻌﯾزﻮﺗ
 
 ﻢﺘﯿﺳ
يﺬﻟا
 ،ﺔﻤﻜﺤﻤﻠﻟ ﻲﻓﺎﺿإ ﻢﺳﺮﻛ ﻲﻓﺎﺿإ ﻞﻜﺸﺑ رﻻود
ﻢﺳﺮﻟا ا
ﺬ
ھ ﻊﻓ
ُﯾ .
ﺪ
23 Pa. C.S. §6106(d)
 ﻲﻓ ﻦﯿﺒﻤﻟا ﻮﺤﻨﻟا ﻰﻠﻋ

 ﮫﯿﻠﺣ

 )ب

 ﮫﯿ

. 

 ﺮﯿ

ﻏ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا نأ ﺖﺒﺜﯾ ﻦﯿﺣ وأ ﮫﯿﺟو ﺐﺒﺳ رﺎﮭظإ ﺪﻌﺑ (

ى. 

ﻮﻋﺪﻟا

ﺬھه 

 ﻒﯿﻟﺎﻜﺗ ﻦﻋ لزﺎﻨﺘﻟا

 
 
 ﻢﺘﯾ ،ﻊﻓﺪﻟا ﻰﻠﻋ ردﺎﻗ

 )ج

 (c) Upon a showing of good cause or finding that 
Defendant is unable to pay, the costs of this action are 
waived. 

 

 

 
 عﺎﻤﺘ

Defendant. 

  

 ﻲﻋﺪﻤﻟا بﺎﺴﺤﻟ رﻻود
 
،ﮫﺒﯿ

 ًﺎ 
ﻐﻠﺒﻣ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻊﻓﺪﯾ .
ﻋﺪﻤﻟا ﺎھﺪﺒﻜﺗ ﺮﺋﺎﺴﺨﻟ ﺾﯾﻮﻌﺘﻛ ________________لﻮﻠﺤﺑ

__________هرﺪﻗ ﻲﻟﺎﻣ

ﺟ ﻦﻣ ﻲ

  

 12

 

(ﺦﯾ
:ﻲﻟﺎﺘﻟا ﻮﺤﻨﻟا ﻰﻠﻋ ﻲھ ﻲ

رﺎﺗ)

 

ﺘﻟاو

                     

       

_____________________________________________ 
_____________________________________________ 
_____________________________________________ 

: 

 
 
ﻲﻟﺎﺘﻟا ﻮﺤﻨﻟا ﻰﻠﻋ تﺎﻌﻓد لوﺪﺟ ﺔﻤﻜﺤﻤﻟا ضﺮﻔﺗ

_____________________________________________ 
_____________________________________________ 

وأ 

 

 ﺐﺳﺎﻨﻣ رﺎﻌﺷﺈﺑ ،سﺎﻤﺘﻟا ﻢﯾﺪﻘﺘﻟ ًﺎﻧذإ ﻲﻋﺪﻤﻟا ﺔﻤﻜﺤﻤﻟا ﻲﻄﻌﺗ
 
 
ﺪﻤﻟا
 
ﻰﻟإ

 
 ______________________________
_____________________________________________ 
_____________________________________________ 
_____________________________________________ 

ﮫﯿﻠﻋ ﻰﻋ

 ،ـﻟ

( 

ﺎﮭﯩﻟإ

 سﺎﻤﺘﻟﻻا اﺬھ ﻢﯾﺪﻘﺗ ﻲﻐﺒﻨﯾ ﻲﺘﻟا

 ﺔﻤﻜ

ﺤﻤﻟا

 وأ

 ﻲﺿﺎﻘﻟا ﻢﺳا ﺮﻛذا)

 

 ًا 
ﺪﻨﺘﺴﻣ سﺎﻤﺘﻟﻻا ﻦﻤﻀﺘﯾ نأ ﻲﻐﺒﻨﯾو .ةﺪﺒﻜﺘﻣ ﺮﺋﺎﺴﺧ ﻦﻋ ﺾﯾﻮﻌﺗ ﺐﻠﻄ
ﺑ
 ًﺎ 
ﻧو ةﺴ
ﺪﺒﻜﺘﻤﻟ
 ﻊ
ﯿﻤﺟ ﻦﻋ ﺦ
ا ﺮﺋﺎﺴﺨﻟا ﻞﻛ جرﺪﯾ لوﺪﺟ ﻰﻠﻋ يﻮﺘﺤﯾ
ﯿﻧﻮﻧﺎﻗ
 ضﺮﻔﺗ
 ﻦﻟ . عﺎﻤﺘﺳا ﺔﺴﻠﺟ
 ﻣأوﺮ 
 
ﺔﻟوﺪﺠﺑ
 تاﺮﯾﺪﻘﺗو ﺮﯿﺗاﻮﻔﻟا
 
.سﺎﻤﺘﻟﻻا اﺬھ ﻢﯾﺪﻘﺗ ﻰﻠﻋ ﺔﻤﻜ
ﺤﻤﻟا ﺐﺗﺎﻛ ﺐﺘﻜﻣ ﺔﻄﺳاﻮﺑ مﻮﺳر يأ

تﺎﺤﯿﻠﺼﺘﻟا

 12. Defendant shall pay $ ____________ to Plaintiff by 

       (Date) 

___________________ as compensation for Plaintiff’s  
 
out-of-pocket losses, which are as follows: 
_____________________________________________ 
_____________________________________________ 
_____________________________________________ 
 An installment Schedule is ordered as follows: 
_____________________________________________ 
_____________________________________________ 

 Plaintiff is granted leave to present a petition, with 
appropriate notice to Defendant, to _________________ 
__________________________________________ 
_____________________________________________ 
      (Insert name of Judge or court to which the petition should be presented) 

equesting recovery of out-of-pocket losses. The  
petition shall include an exhibit itemizing all claimed  
out-of-pocket losses, copies of all bills and estimates of  
repair, and an order scheduling a hearing. No fee shall  
be required by the prothonotary’s office for the filing of 
this petition. 

R 

  O

  

  r

 13. THIS ORDER SUPERSEDES ANY PRIOR 

 ﻲﻋﺪﻤﻟا ﮫﯿﻠﻋ ﻞﺼﺣ ﻖﺑﺎﺳ ةءﺎﺳ

إ ﻦﻣ ﺔﯾﺎﻤﺣ ﺮﻣأ يأ ﺮﻣﻷا اﺬھ ﻞﻄﺒُﯾ
.ﮫﺗاذ ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﺪﺿ ﮫﺗاذ

 

 13. 

 

 

 

ﺮﻣ 

ﻷا اﺬھ مﺎﻜﺣأ ﻞﻛ
 
 
(ﺪﺣاو ﻊﺑﺮﻣ ﻰﻠﻋ ﺔﻣﻼﻋ ﻊﺿ)
__________ﺦﯾرﺎﺘﺑ ،__________ﻲﻓ

لﻮﻌﻔﻣ

 ﻲﮭﺘﻨ

 

 

  

 14ﯾ .
 
          

 

(ﺦﯾرﺎﺗ)

      

 

(ﺮﮭﺷأ وأ مﺎﯾأ)

     

وأ 

 

 
. 
__________________________________________ 
(ﺦﯾرﺎﺘﻟا) 

تاﻮﻨﺳ ثﻼﺛ لﻼ
 

 ﺧ

 in three years on  
_________________________________________.  

  _

(Date) 

PROTECTION FROM ABUSE ORDER OBTAINED BY 
THE SAME PLAINTIFF AGAINST THE SAME 
DEFENDANT. 

 
 14. All provisions of this order shall expire 
          (Check one): 

 in _________________, on _________________  

                               (Days, months, or years)  

      (Date) 

R 

  O

 

 

 

 

 

   

             

ENGLISH/ARABIC  PFA Final Order                                                             Page 7 of 9 / 9 ﻦﻣ 
Pa. R.C.P 1905(e) Rev. 3-19 

 7 ﺔﺤﻔﺻ 

 

                      AOPC Rev. 4-2019 

 
NOTICE TO DEFENDANT 
 

 DEFENDANT IS HEREBY NOTIFIED THAT FAILURE TO OBEY THIS ORDER MAY RESULT IN ARREST AS SET 

FORTH IN 23 PA.C.S. § 6113 AND THAT VIOLATION OF THE ORDER MAY RESULT IN A CHARGE OF INDIRECT 
CRIMINAL CONTEMPT AS SET FORTH IN 23 PA.C.S. § 6114. VIOLATION MAY ALSO SUBJECT YOU TO PROSECUTION 
AND CRIMINAL PENALTIES UNDER THE PENNSYLVANIA CRIMES CODE. A VIOLATION OF THIS ORDER MAY 
RESULT IN THE REVOCATION OF THE SAFEKEEPING PERMIT, WHICH WILL REQUIRE THE IMMEDIATE 
RELINQUISHMENT OF YOUR FIREARMS, OTHER WEAPONS, AND AMMUNITION TO THE SHERIFF OR THE 
APPROPRIATE LAW ENFORCEMENT AGENCY. PLAINTIFF’S CONSENT TO CONTACT BY DEFENDANT SHALL NOT 
INVALIDATE THIS ORDER, WHICH CAN ONLY BE MODIFIED BY FURTHER ORDER OF COURT. 23 Pa. C.S. §6108(g). 

THIS ORDER IS ENFORCEABLE IN ALL FIFTY (50) STATES, THE DISTRICT OF COLUMBIA, TRIBAL LANDS, 

US TERRITORIES, AND THE COMMONWEALTH OF PUERTO RICO UNDER THE VIOLENCE AGAINST WOMEN ACT, 18 
U.S.C. §2265. IF YOU TRAVEL OUTSIDE OF THE STATE AND INTENTIONALLY VIOLATE THIS ORDER, YOU MAY BE 
SUBJECT TO FEDERAL CRIMINAL PROCEEDINGS UNDER THAT ACT. 18 U.S.C. §§2261-2262. IF YOU POSSESS A 
FIREARM OR ANY AMMUNITION WHILE THIS ORDER IS IN EFFECT, YOU MAY BE CHARGED WITH A FEDERAL 
CRIMINAL OFFENSE EVEN IF THIS PENNSYLVANIA ORDER DOES NOT EXPRESSLY PROHIBIT YOU FROM 
POSSESSING FIREARMS OR AMMUNITION UNDER 18 U.S.C. §922(g)(8) OR STATE CRIMINAL OFFENSES AND STATE 
CRIMINAL PENALTIES UNDER 18 PA.C.S. § 6105. 

 
ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﻰﻟإ رﺎﻌ

ﺷإ

ﺤﻣ
ﺎ
ﻟ
ﻔ
ﺔ
 
ﻦﻋ ﺞﺘﻨﯾ ﺪﻗ ﺚﯿﺣ
 
 
23 Pa.C.S. § 6113 
صﻮﺼﻨﻤﻟا
 
ﻋ
ﯿ
ﻠ
ﮫ
 
ﻓ
ﻲ
ﻮﺤﻨﻟ
 
ﻋ
 
ﻠ
ﻰ
 
ا
ﮫ
ا
 
ﻟ
ﻘ
ﺒ
ﺾ
 
يدﺆﯾ ﺪﻗ اﺬھ ﺔﻤﻜﺤﻤﻟا
إ
 
ﻟ
ﻰ
ﻋ
ﯿ
ﻠ
 
مﺪﻋﻣﺘلﺎﺜ ﺮﻣﻷ 
 
ا
ﻹ
ﮫ
ﯿ
 
ﺄ
ﺑ
ن
 
ﻰﻋﺪﻤﻟ
 
ﻋ
ﻠ
غﻼﺑإ ﮫﺒﺟﻮﻤﺑ
ا
 
ﯾ 
ﺘ
ﻢ
ً
ً
ت
ﺔ
ﺎ
ا
ﻟ
 
ﺠ
ﺎ
ﻨ
ﺋ
ﯿ
 
و
ﻓ
ﺎ
ﻘ
 
ﻟ
ا
ﻌ
ﻘ
ﻮ
ﺑ
ﻤ
ﻟ
ﻘ
ﺎ
ﺿ
ﺎ
ة
 
و
ﻚﺿ
أ
 
ﯾ
ﻀ
 
ﺎ
إ
ﻟ
ﻰ
ا
 
ﺮﻌﺗ ﺪﻗ ﺮﻣﻷا اﺬھ ﺔﻔﻟﺎﺨﻣ
 
. 23 Pa.C.S. §6114
صﻮﺼﻨﻤﻟا ﻮﺤﻨﻟا ﻰﻠﻋ
 
ﻋ
ﯿ
ﮫ
 
ﻲ
ﻠ
 
ﻓ
ﺮﺷﺎﺒﻤﻟا ﺮﯿﻏ ﻲﺋﺎﻨﺠﻟا نﺎﯿﺼﻌﻟا
 
ﺮﻣﻷا اﺬھ
 
 
ىﺮﺧﻷأو 
إ
ﻟ
ﻰ
 
ﻟ
ﻐ
ﺎ
ء
 
ﺔﺤﻠﺳﻷاو ﺔﯾرﺎﻨﻟا ﺔﺤﻠﺳﻸﻟ يرﻮﻔﻟا ﻢﯿﻠﺴﺘﻟا ﺐﻠﻄﺘﺘﺳ ﻲﺘﻟا ،ﻚﻟ ﺔﻌﺑﺎﺘﻟا ﻦﻣﻵا ظﺎﻔﺤﻟا ﺔﺼﺧر
ﺮﻣﻷا اﺬھ ﺔﻔﻟﺎﺨﻣ يدﺆﺗ ﺪﻗ ﺎﻤﻛ .ﺎﯿﻧﺎﻔﻠﺴﻨﺒﻟ تﺎﯾﺎﻨﺠﻟا نﻮﻧﺎﻘﻟ
 
ا
 
إ
ﻰ
ﻠ
نﻮﻧ .ﻣ نإ
ﺎ
ﺈ
ﻧ
ﻔ
ﻟ
 
 
ﺧﺬﻟا
ﯿ
ﺮ
ﺪﻌﺗ ﻦﻜﻤﯾ ﻻ يﺬﻟا ،ﺮﻣﻷا اﺬھ ﻲﻐ
ﯾ
ﻠ
ﮫ
 
ﻻ
إ
 
ﻰﻋﺪﻤﻟا
 
ﻋ
ﯿ
ﻠ
ﮫ
 
ﻻ
ﯾ
 
ﻠ
ﻌ
ﻨ
ﻲ
 
ﺑ
ﺎ
ذ
 
ا
ﻟ
ﻘ
ﺐﺳﺎﻨﻤﻟا زﺎﮭﺠﻟا
ا
ﻤ
ﺮﺸﻟاﻒ  وأ
 
ﯾ
إ
 
ﻟ
ﻰ
ﺔﺻﺎﺨﻟا
 
ﻚ
ﺑ
ة
 
ﺔﻄﺳاﻮﺑ لﺎﺼﺗﻻا
ﻲﻋﺪﻤﻟا ﺔﻘﻓاﻮ
 
ﻋ
 
 
.
23 Pa C.S. §6108
g
.
ﺔﻤﻜﺤﻤﻟ
ﻦﻣ ﺮﺧآ
 
ا
 
ﺮﻣأ ﺮﺒﻋو
 
ضﺮﻐﻟا اﺬﮭﻟ ﺔﺒﺳﺎﻨﻣ ﺔﻤﻜﺤﻣ قاروأ
 
ﺑ
ﺈ
ﯾ
ﺪ
ا
ع
 
ﻌ
ﺎ
ﻓ
ﺬ
 
ا
ﻟ
ﻤ
ﻔ
50
ﺴﻤﺨﻟ
ا
ﯿ
ﻦ
 
)
ﻻﻮﻟا ﻊﯿﻤﺟ ﻲﻓ لﻮ
ﺎ
ﯾ
ت
 
ﺮﻣﻷا اﺬھ
ﻧ
 
ﻟ
 
ﺪﺿ ﻒﻨﻌﻟا
 
ا
ﻨ
ﺴ
ﺎ
ء
،
18 U.S.C. §§2261-
جرﺎﺧ ﻰﻟإ تﺮﻓﺎﺳ اذإ .
نﻮﻧﺎﻘﻟ
.
 
ﻰﻀﺘﻘﻤﺑ ﺔﯿﻟارﺪﻓ
 
ذ
ﻟ
ﻚ
ا
 
 
ﺔ
ﺮﺟإ ﻰﻟإ ضﺮﻌﺘﺗ ﺪﻘﻓ ﺪﻤﻋ ﻦﻋ ﺮﻣﻷا اﺬھ
ا
ء
ا
ت
 
ﺟ
ﺎ
ﻨ
ﺋ
ﯿ
ﺧو
ﻟ
ﺎ
ﻔ
ﺖ
 
ﻻﻮﻟاﺔﯾ 
 
18 U.S.C.  §2265
 
ة
ﻦﻣ ﺔﺣاﺮﺻ ﻚﻌﻨﻤﯾ ﻻ ﺎﯿﻧﺎﻔﻠﺴﻨﺑ ﻲﻓ ردﺎﺼﻟا ﺮﻣﻷا نﺎﻛ نإو ﻰﺘﺣ ﻲﻟارﺪﻓ مﺮﺠﺑ ﻢﮭﺘﺗ ﺪﻘﻓ ،ﺮ
 
ﺣ
ﺎ
ﯿ
ز
ﻣﻷا اﺬھ لﻮﻌﻔﻣ نﺎﯾﺮﺳ لﻼﺧ ةﺮﯿﺧذ
أ
 
ﯾ
ﺔ
 
يرﺎﻧ حﻼ
أ
 
و
ﺳ
 
 ﻚﺗزﻮﺤﺑ
.
إ
 
ذ
ا
 
ﻛ
ﺎ
ن
2262
 
.
18 PA.C.S. § 6105
ﺐﺟﻮﻤﺑ
 
 
ﻻﻮﻟﺎﺑ ﺔﺻﺎﺨﻟا ﺔﯿﺋﺎﻨﺠ
ﯾ
ﺔ
ﺮﺟﻹ
ا
ا
ﻣ
ﯿ
ﺔ
 
و
ﻟ
ا
ﻌ
ﻘ
ﻮ
ﺎ
ﺑ
ت
ا
 
ﻟ
أ
 
و
 
ﻷ
ا
ﻓ
ﻌ
ﺎ
ل
 
18 U.S.C. §922(g)(8)
 
ﺧذ وأ ﺔﯾرﺎﻧ ﺔﺤﻠﺳأ
ﯿ
ﺮ
ة
.

رﻮﺑ
 
ﻣﻮﻛ
و
ﻨ
ﻮ
ﻟ
ﺚ
ﺪﺤﺘﻤﻟا تﺎﯾﻻﻮﻠﻟ ﺔﻌﺑﺎﺘﻟا
ة
 
 
ﻢ
و
 
ا
ﻷ
ﻗ
ﻟ
ﺎ
ﯿ
ا
ﻲﺿارﻷاو ﺎﯿﺒﻣﻮﻟ
ﻟ
 
ﻘ
ﻠ
ﺒ
ﯿ
ﺔ

ﺔﺤﻓﺎﻜﻣ نﻮﻧﺎﻘﻟ ًﺎﻘﻓو ﻮﻜﯾرﻮﺗ
 

ﻮﻛ ﺔﻌطﺎﻘﻣو ،(

NOTICE TO SHERIFF, POLICE, AND LAW ENFORCEMENT OFFICIALS 
 

The police and sheriff who have jurisdiction over Plaintiff's residence OR any location where a violation of this 

 
order occurs OR where Defendant may be located, shall enforce this order. The court shall have jurisdiction over any 
indirect criminal contempt proceeding, either in the county where the violation occurred or where this protective order 
was entered. An arrest for violation of Paragraphs 1 through 7 of this order may be without warrant, based solely on 
probable cause, whether or not the violation is committed in the presence of the police or any sheriff. 23 Pa. C.S. §6113. 
 

Subsequent to an arrest, and without the necessity of a warrant, the police officer or sheriff shall seize all firearms, 

other weapons, and ammunition in Defendant's possession that were used or threatened to be used during the violation of 
the protection order or during prior incidents of abuse and any other firearms in Defendant's possession.  
 

The______________________________________________________________________________________ 

shall maintain possession of firearms, other weapons, or ammunition until further order of the court. 

(Insert the appropriate name or title) 

When Defendant is placed under arrest for violation of the order, Defendant shall be taken to the appropriate authority or 
authorities before whom Defendant is to be arraigned. A "Complaint for Indirect Criminal Contempt" shall then be 
completed and signed by the police officer, sheriff, OR Plaintiff. Plaintiff's presence and signature are not required to file 
this complaint. 

If sufficient grounds for violation of this order are alleged, Defendant shall be arraigned, bond set, if appropriate, 

and both parties given notice of the date of the hearing. 

   

   

 

 

   

     

ENGLISH/ARABIC  PFA Final Order                                                             Page 8 of 9 / 9 ﻦﻣ 
Pa. R.C.P 1905(e) Rev. 3-19 

 8 ﺔﺤﻔﺻ 

 

                      AOPC Rev. 4-2019 

________________________________________ 

  _

BY THE COURT / 

ﺑ
ﺔﻤﻜﺤ
ﻤ
ﺔﻄﺳاﻮ
ا
 
ﻟ
 

_________________________________________ 

Judge / ﻲﺿﺎﻘﻟا 
 

Date / ﺦﯾرﺎﺘﻟا 

 
نﻮﻧﺎﻘﻟا ﻖﯿﺒﻄﺗ ﻲﻟوﺆﺴﻣو ﺔطﺮﺸﻟاو
 
ﻒ
ﺮﺸﻟا
ﯾ
ﺷإ
ﻌ
ﺎ
ر
إ
 
ﻟ
ﻰ
 

 
أ ﯿﺣ ﺚ
 
ﻋ
ﻟ
 
ص
 
ﺮﺸﻟا
 
ﺎ
ﺮﻣﻷا اﺬھ
و
 
ﺮﻣﻷا اﺬﮭ
ا
 
ﻟ
ﻘ
ﻀ
ﺋ
ﺎ
ﻲ
ﻟ
 
ﺨﻣ ﮫﯿﻓ ثﺪﺤﺗ ﻊﻗﻮﻣ يأ
ﻟ
ﺎ
ﻔ
ﺔ
أ 
 
و
ﻲﻋﺪﻤﻟا ﺔﻣﺎﻗإ ﺔﻘﻄ
ﺧﻻا
ﺘ
ﺼ
ﺎ
ا
ﻘ
ﻀ
ﺋ
ﺎ
ﻲ
ﻠ
ﻰ
 
ﻣ
ﻨ
 
ﻢﮭﻟ ﻦﯾﺬﻟا
 
ﻒ
ﯾ
ﺔطﺮﺸﻟا
أ
 
و
 
ﮭﺟ 
ز
ﯾ 
ﺬ
ﻨ
ﻔ
ﻢ
 
 ﺚﯿﺣ وأ ﺔﻔﻟﺎﺨﻤﻟا ﺖﺛﺪﺣ ﺚﯿﺣ ﺔﻌطﺎﻘﻤﻟا ﻲﻓ ﺎﻣإ ،ةﺮﺷﺎﺒﻣ ﺮﯿﻏ ﺔﯿﺋﺎﻨﺟ نﺎﯿﺼﻋ تا
 ﻲﺋﺎﻀﻘﻟا
ﻰ
 
ﺮﺟإ يأ
ﺗ
ا
ء
ﻋ
ﻠ
 صﺎﺼﺘﺧﻻا ﺔﻤﻜﺤﻤﻟا ﻚﻠﻤﺗ .ﮫﯿﻠ
 ﻰﻋﺪ
ﻋ
 ﺪﺟاﻮﺘﯾ
ﻟ
ا
ﻤ
ﺐﺴﺤ
،
 
ﺟ
ﻮ
ﯿ
ﮫ
 
ﻓ
ﻞﻤﺘﺤﻤ
أ
 
و
ا
 
ﻟ
،
ﻒ
 
ﻋ
ﻠ
ﻰ
 
ﺳ
أ
ﺎ
س
ا
 
ﻟ
ﺴ
ﺒ
ﺐ
ا
 
ﻟ
ﺗ
 
ﻮ
ﻗ
ﯿ
ﺮﻣأ نود ﺮﻣﻷا اﺬھ
 ﻦﻣ 1  ﻰﻟإ7  ﻦﻣ
ﻟ
ﺎ
ﻔ
ﺔ
 
ا
ﻟ
ﻔ
ﻘ
ﺮ
ا
ت
ﺨﻣ ﺐﺒﺴﺑ لﺎﻘﺘﻋﻻا ﻢﺘﯾ نأ ﻦﻜﻤﯾ .اﺬھ ﺔﯾﺎﻤﺤﻟا ﺮﻣأ راﺪﺻإ
ﺨﻤﻟا ﺖﻤﺗ ءاﻮﺳ
.
  وأﻒﯾﺮﺸﻟا
 
ﻀﺣ ﻲﻓ ﻢﺘﺗ ﻢ
ﻟ
ﻟ
ﺎ
ﻔ
ﺔ
أ
 
و
 
 
.
23 Pa. C.S. §6113
 
 نﻮﻜﺗ 
ﻰﻋﺪﻤﻟا ةزﻮﺤﺑ
ﺔﺤﻠﺳﻷا ﺔﻓﺎﻛ ةردﺎﺼﻤﺑ
ﻒ
ﻲطﺮﺸﻟا مﻮﻘﯾ ،
ﺮﺸﻟا
ﺮﻣﻷ ﺔﺟﺎﺤﻟا نودو ،لﺎﻘﺘﻋﻻا ﺪﻌﺑ
 
 
ﻋ
ﯿ
ﻠ
ﮫ
 
 
ﺧﺬﻟاو ىﺮﺧﻷا ﺔﺤﻠﺳﻷا
ﯿ
ﺮ
ة
ا
 
ﻟ
ﺘ
ﻲ
ا
 
ﻟ
ﻨ
ﺎ
ر
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ﺎ
ﺑ
 
ﺎ
ﺳ
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ﻤﻌﺘﺳا ﻢﺗ ﻲﺘﻟا
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رﻮ

 

 

 
__________

___________________________________________________________________ـﻟا

 
(
ﺐﺳﺎﻨﻤﻟا ﺐﻘﻠﻟا وأ ﻢﺳﻻا ﺮﻛذا)

 
.
ﺔﻤﻜﺤﻤﻟا
 
ﻦﻣ ﺮﺧآ ﺮﻣأ روﺪﺻ ﻰﺘﺣ ةﺮﯿﺧﺬﻟ

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ﺘ
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ﻋ
ﺎ
ﺔﺼﺘﺨﻤﻟا تﺎﻄﻠﺴﻟا وأ ﺔﻄﻠﺴﻟا ﻰﻟإ ﮫﻤﯿﻠﺴﺗو ﮫﯿﻠﻋ ﻰﻋﺪﻤﻟا ﺬﺧأ ﺐﺠﯾ ،ﺔﻤﻜﺤﻤﻟا ﺮﻣأ ﮫﺘﻓﺎﺨﻤﻟ ﮫﯿﻠﻋ ﻰﻋﺪﻤ
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ﺎ
 
ﮭﻣﺎﻣأ لﻮﺜﻤﻠﻟ
ىﻮﻜﺸﻟا هﺬھ ﻢﯾﺪﻘﺗ ﻢﺘﯾ ﻲﻛ ﮫﻌﯿﻗﻮﺗو ﻲﻋﺪﻤﻟا رﻮﻀﺣ
 
.
 
ﻼﻛ ءﺎﻄﻋإو ،ًﺎﺒﺳﺎﻨﻣ نﺎﻛ اذإ ،
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ﻰﻋﺪﻤﻟا ءﺎﻋﺪﺘﺳا ﻢﺘﯾ ،ﺮﻣﻷا اﺬھ ﺔﻔﻟﺎﺨﻤﻟ
 
ﻋ
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ﺔ
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ﻛ
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.
ﺳﻻا ﺔﺴﻠﺟ ﺦﯾرﺎ
ﺘ
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ع
 

This order was entered pursuant to the consent of Plaintiff and Defendant: 
ﻋ(: 
ﻠ
ﮫ
ﯿ
ﻰﻋﺪﻤﻟاو ﻲﻋﺪﻤ
 
ﻮﻣ ﺐﺟﻮﻤﺑ
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ﺮﻣﻷا اﺬھ

 ﻢﺗ راﺪﺻإ
)

_________________________________________ 
Plaintiff’s signature (ﻲﻋﺪﻤﻟا ﻊﯿﻗﻮﺗ) 

        _______________________________________________ 

                                           Defendant's signature 

)
ﻰﻋﺪﻤ
ﻟ
 
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ﯿ
ﻠ
ﮫ
(
ﻗ
ﯿ
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ا
 
ﺗ
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_________________________________________                ______________________________________________ 

Attorney for Plaintiff’s signature 
    
 

              (ﻲﻋﺪﻤﻟا ﻲﻣﺎﺤﻣ ﻊﯿﻗﻮﺗ)
 

 

 
 
  
            

 
             

Attorney for Defendant’s signature 
)
             
 
(
ﻰﻋﺪﻤﻟ
 
ﻋ
ﯿ
ﻠ
ﮫ
ﻲﻣﺎﺤ
ﻣ
 
ا
ﺗ
ﻮ
ﻗ
ﯿ
ﻊ
 
 

 

 

     

  _

  _

ENGLISH/ARABIC  PFA Final Order                                                             Page 9 of 9 / 9 ﻦﻣ 
Pa. R.C.P 1905(e) Rev. 3-19 

 9 ﺔﺤﻔﺻ 

 

                      AOPC Rev. 4-2019

FINAL PROTECTION FROM

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): 9
Fields(s): 213
Average fields per page: 23
Reading Level: Grade 15
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.

n_th_e_cour_f_commo_plea was IN THE COURT OF COMMON PLEAS OF (0.65 conf)
extended_order was Extended Order (0.31 conf)
amended_order was Amended Order (0.41 conf)
plaintiff__1 was PLAINTIFF (1.00 conf)
protected_minor_children__1 was Names of all protected persons including minor children and DOB 1 (0.35 conf)
protected_minor_children__2 was Names of all protected persons including minor children and DOB 2 (0.35 conf)
defendant was DEFENDANT (1.00 conf)
suffix was Suffix (0.41 conf)
defendants_address__1 was Defendants address 1 (0.31 conf)
defendants_address__2 was Defendants address 2 (0.31 conf)
users1_birthdate was DOB (1.00 conf)
height was HEIGHT (0.36 conf)
sex was SEX (0.38 conf)
weight was WEIGHT (0.36 conf)
race was RACE (0.41 conf)
eyes was EYES (0.34 conf)
eye was EYES_2 (0.30 conf)
ssn was SSN (0.34 conf)
weapon_involved was Weapon Involved (0.37 conf)
weapon_present_property was Weapon Present on Property (0.43 conf)
weapon_ordered_relinquished was Weapon Ordered Relinquished (0.40 conf)
driver_license was DRIVERS LICENSE (0.46 conf)
ex_p_date was EXP DATE (0.32 conf)
users1_address_state was STATE (1.00 conf)
defendant_shall_threaten_attempt was Defendant shall not abuse harass stalk threaten or attempt or threaten to use physical force against any of the above persons in (0.40 conf)
defendant_shall_protected was Except as provided in Paragraph 5 of this order Defendant shall not contact Plaintiff or any other person protected under (0.43 conf)
additional_findings_order_set was Additional findings of this order are set forth below (0.36 conf)
order_expiration_date was Order Expiration date (0.40 conf)
undefined__1 was undefined (0.38 conf)
text__1 was Text8 (0.35 conf)
toggle__1 was toggle_1 (0.38 conf)
toggle__2 was toggle_2 (0.38 conf)
fill__1 was fill_12 (0.36 conf)
fill__2 was fill_1 (0.36 conf)
fill__3 was fill_2 (0.36 conf)
fill__4 was fill_13 (0.36 conf)
fill__5 was fill_9 (0.36 conf)
fill__6 was fill_14 (0.36 conf)
fill__7 was fill_10 (0.36 conf)
fill__8 was fill_15 (0.36 conf)
fill__9 was fill_16 (0.36 conf)
fill__10 was fill_3 (0.36 conf)
fill__11 was fill_4 (0.36 conf)
fill__12 was fill_17 (0.36 conf)
toggle__3 was toggle_3 (0.38 conf)
toggle__4 was toggle_4 (0.38 conf)
toggle__5 was toggle_5 (0.38 conf)
toggle__6 was toggle_6 (0.38 conf)
toggle__7 was toggle_7 (0.38 conf)
toggle__8 was toggle_8 (0.38 conf)
fill__13 was fill_7 (0.36 conf)
fill__14 was fill_6 (0.36 conf)
text__2 was Text1 (0.35 conf)
spouse_former_defendant was spouse or former spouse of Defendant (0.47 conf)
parent_child_defendant was parent of a child with Defendant (0.38 conf)
current_sexual_partner was current or former sexual or intimate partner with Defendant (0.53 conf)
child_plaintiff was child of Plaintiff (0.46 conf)
child_defendant was child of Defendant (0.50 conf)
family_related_blood was family member related by blood consanguinity to (0.28 conf)
family_related_marriage was family member related by marriage or affinity to (0.42 conf)
sibling_person_defendant was sibling person who shares parenthood of Defendant (0.38 conf)
agreement was By Agreement (0.43 conf)
agreement_without_admission was By Agreement without an admission (0.42 conf)
hearing_decision_court was After a hearing and decision by the court (0.37 conf)
hearing_defendant_despite was After Hearing at which defendant was not present despite (0.47 conf)
toggle__9 was toggle_9 (0.38 conf)
toggle__10 was toggle_10 (0.38 conf)
toggle__11 was toggle_11 (0.38 conf)
toggle__12 was toggle_12 (0.38 conf)
toggle__13 was toggle_13 (0.38 conf)
toggle__14 was toggle_14 (0.38 conf)
toggle__15 was toggle_15 (0.38 conf)
toggle__16 was toggle_16 (0.38 conf)
toggle__17 was toggle_24 (0.38 conf)
toggle__18 was toggle_25 (0.38 conf)
toggle__19 was toggle_26 (0.38 conf)
toggle__20 was toggle_27 (0.38 conf)
unknown__1 was 20 (0.38 conf)
default was By Default (0.45 conf)
toggle__21 was toggle_28 (0.38 conf)
toggle__22 was toggle_29 (0.38 conf)
plaintiff__2 was Plaintiff (1.00 conf)
toggle__23 was toggle_30 (0.38 conf)
plaintiff__3 was Plaintiff_2 (0.54 conf)
text__3 was Text3 (0.35 conf)
text__4 was Text4 (0.35 conf)
text__5 was Text5 (0.35 conf)
text__6 was Text6 (0.35 conf)
text__7 was Text7 (0.35 conf)
defendant_shall_harass was 1 Defendant shall not abuse stalk harass threaten or (0.53 conf)
completely_evicted_excluded was 2 Defendant is completely evicted and excluded from the (0.35 conf)
residence was residence at (0.30 conf)
fill__15 was fill_1_2 (0.40 conf)
address_defendant was Nonconfidential address from which Defendant is excluded (0.38 conf)
fill__16 was fill_3_2 (0.40 conf)
order was this order (0.42 conf)
toggle__24 was toggle_6_2 (0.33 conf)
on was On (0.33 conf)
fill__17 was fill_5 (0.36 conf)
fill__18 was fill_7_2 (0.40 conf)
fill__19 was fill_8 (0.36 conf)
officer_retrieval_made was officer or sheriff when such retrieval is made and (0.39 conf)
insert_conditions was insert any other conditions (0.39 conf)
except_provided_paragraph__1 was 3 Except as provided in Paragraph 5 of this order (0.37 conf)
locations_duration_order__1 was locations for the duration of this order 1 (0.39 conf)
locations_duration_order__2 was locations for the duration of this order 2 (0.39 conf)
locations_duration_order__3 was locations for the duration of this order 3 (0.39 conf)
fill__20 was fill_11_2 (0.40 conf)
fill__21 was fill_13_2 (0.40 conf)
fill__22 was fill_15_2 (0.40 conf)
fill__23 was fill_17_2 (0.40 conf)
except_provided_paragraph__2 was 4 Except as provided in Paragraph 5 of this order (0.37 conf)
unknown__2 was 4 (0.38 conf)
custody_minor_children was 5 Temporary custody of the minor children NAMES (0.40 conf)
unknown__3 was 5 (0.38 conf)
fill__24 was fill_18 (0.36 conf)
f_thi_paragrap_h__1 was OF THIS PARAGRAPH 1 (0.42 conf)
f_thi_paragrap_h__2 was OF THIS PARAGRAPH 2 (0.42 conf)
f_thi_paragrap_h__3 was OF THIS PARAGRAPH 3 (0.42 conf)
1_2 was 1_2 (0.38 conf)
2_2 was 2_2 (0.38 conf)
partial_custody_visitation__1 was partial custody or visitation if any 1 (0.37 conf)
partial_custody_visitation__2 was partial custody or visitation if any 2 (0.37 conf)
partial_custody_visitation__3 was partial custody or visitation if any 3 (0.37 conf)
fill__25 was fill_5_2 (0.40 conf)
fill__26 was fill_7_3 (0.40 conf)
fill__27 was fill_8_2 (0.40 conf)
current_custody_order was There is a current custody order as to the (0.45 conf)
children_parties__1 was children of the parties 1 (0.40 conf)
children_parties__2 was children of the parties 2 (0.40 conf)
fill__28 was fill_10_2 (0.40 conf)
fill__29 was fill_12_2 (0.40 conf)
toggle__25 was toggle_2_2 (0.33 conf)
custody_petition_pending was A custody petition is pending (0.54 conf)
undefined__2 was undefined_3 (0.39 conf)
toggle__26 was toggle_5_2 (0.33 conf)
toggle__27 was toggle_6_3 (0.33 conf)
hearing_scheduled was A hearing is scheduled for (0.31 conf)
fill__30 was fill_14_2 (0.40 conf)
thi_orde_r_shal_l_supersed_e was THIS ORDER SHALL NOT SUPERSEDE THE (0.46 conf)
toggle__28 was toggle_9_2 (0.33 conf)
toggle__29 was toggle_10_2 (0.33 conf)
thi_orde_r_supersede_prior__1 was THIS ORDER SUPERSEDES ANY PRIOR (0.42 conf)
firearm_r_weapon_ammunition was 6 FIREARMS OTHER WEAPONS OR AMMUNITION (0.36 conf)
unknown__4 was 6 (0.38 conf)
defendant_acquiring was Defendant is prohibited from possessing or acquiring (0.46 conf)
toggle__30 was toggle_16_2 (0.33 conf)
toggle__31 was toggle_17 (0.38 conf)
defendant_shall_sheriff was Defendant shall relinquish to the sheriff or the (0.33 conf)
licenses_possessed_defendant__1 was licenses owned or possessed by Defendant 1 (0.49 conf)
licenses_possessed_defendant__2 was licenses owned or possessed by Defendant 2 (0.49 conf)
licenses_possessed_defendant__3 was licenses owned or possessed by Defendant 3 (0.49 conf)
fill__31 was fill_15_3 (0.40 conf)
fill__32 was fill_17_3 (0.40 conf)
fill__33 was fill_19 (0.36 conf)
toggle__32 was toggle_18 (0.38 conf)
defendant_relinquish_sheriff was Defendant is directed to relinquish to the sheriff or the (0.34 conf)
firearm_delivered_sheriff_appropriate was 7 Any firearm delivered to the sheriff or the appropriate (0.45 conf)
pennsylvania_state_municipal was 8 The Pennsylvania State Police the municipal police or (0.52 conf)
additional_granted_authorized was 9 The following additional relief is granted as authorized (0.41 conf)
pay_temporary_support was 10 Defendant is directed to pay temporary support for (0.43 conf)
undefined__3 was undefined_4 (0.39 conf)
defendant_prohibited_stalking was Defendant is prohibited from stalking as (0.43 conf)
toggle__33 was toggle_8_2 (0.33 conf)
relief was Other relief (0.41 conf)
undefined__4 was undefined_5 (0.39 conf)
fill__34 was fill_16_2 (0.40 conf)
fill__35 was fill_18_2 (0.40 conf)
fill__36 was fill_20 (0.36 conf)
fill__37 was fill_5_3 (0.40 conf)
fill__38 was fill_7_4 (0.40 conf)
1_3 was 1_3 (0.38 conf)
2_3 was 2_3 (0.38 conf)
follows__1 was as follows 1 (0.46 conf)
follows__2 was as follows 2 (0.46 conf)
follows__3 was as follows 3 (0.46 conf)
fill__39 was fill_11_3 (0.40 conf)
fill__40 was fill_13_3 (0.40 conf)
fill__41 was fill_15_4 (0.40 conf)
unknown__5 was 11 (0.38 conf)
undefined__5 was undefined_8 (0.39 conf)
defendant_shall_pay was 12 Defendant shall pay (0.39 conf)
thi_orde_r_supersede_prior__2 was 13 THIS ORDER SUPERSEDES ANY PRIOR (0.35 conf)
provisions_order_expire was 14 All provisions of this order shall expire (0.49 conf)
b_order_followed_contested was b Because this order followed a contested (0.41 conf)
plaintiff_granted_petition was Plaintiff is granted leave to present a petition with (0.50 conf)
toggle__34 was toggle_14_2 (0.33 conf)
toggle__35 was toggle_13_2 (0.33 conf)
toggle__36 was toggle_6_4 (0.33 conf)
toggle__37 was toggle_7_2 (0.33 conf)
upon_showing_good_cause_finding was c Upon a showing of good cause or finding that (0.42 conf)
compensation_plaintiffs was as compensation for Plaintiffs (0.41 conf)
fill__42 was fill_2_2 (0.40 conf)
unknown__6 was 12 (0.38 conf)
toggle__38 was toggle_8_3 (0.33 conf)
appropriate_notice_defendant__1 was appropriate notice to Defendant to 2 (0.46 conf)
appropriate_notice_defendant__2 was appropriate notice to Defendant to 3 (0.46 conf)
in was in (0.31 conf)
days_months_years was Days months or years (0.38 conf)
signature_date__1 was Date_2 (1.00 conf)
toggle__39 was toggle_21 (0.38 conf)
three_years was in three years on (0.34 conf)
toggle__40 was toggle_22 (0.38 conf)
signature_date__2 was Date_3 (1.00 conf)
fill__43 was fill_15_5 (0.40 conf)
the was The (0.31 conf)
fill__44 was fill_7_5 (0.40 conf)
fill__45 was fill_8_3 (0.40 conf)
fill__46 was fill_3_3 (0.40 conf)
attorney_plaintiffs_signature was Attorney for Plaintiffs signature (0.51 conf)
attorney_defendants_signature was Attorney for Defendants signature (0.46 conf)
text__8 was Text9 (0.35 conf)
users1_signature was Signature10 (1.00 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

n_th_e_cour_f_commo_plea
extended_order
amended_order
plaintiff__1
protected_minor_children__1
protected_minor_children__2
defendant
suffix
defendants_address__1
defendants_address__2
users1_birthdate
height
sex
weight
race
eyes
eye
ssn
weapon_involved
weapon_present_property
weapon_ordered_relinquished
driver_license
ex_p_date
users1_address_state
defendant_shall_threaten_attempt
defendant_shall_protected
additional_findings_order_set
order_expiration_date
undefined__1
text__1
toggle__1
toggle__2
fill__1
fill__2
fill__3
fill__4
fill__5
fill__6
fill__7
fill__8
fill__9
fill__10
fill__11
fill__12
toggle__3
toggle__4
toggle__5
toggle__6
toggle__7
toggle__8
fill__13
fill__14
text__2
spouse_former_defendant
parent_child_defendant
current_sexual_partner
child_plaintiff
child_defendant
family_related_blood
family_related_marriage
sibling_person_defendant
agreement
agreement_without_admission
hearing_decision_court
hearing_defendant_despite
toggle__9
toggle__10
toggle__11
toggle__12
toggle__13
toggle__14
toggle__15
toggle__16
toggle__17
toggle__18
toggle__19
toggle__20
unknown__1
default
toggle__21
toggle__22
plaintiff__2
toggle__23
plaintiff__3
text__3
text__4
text__5
text__6
text__7
defendant_shall_harass
completely_evicted_excluded
residence
fill__15
address_defendant
fill__16
order
toggle__24
on
fill__17
fill__18
fill__19
officer_retrieval_made
insert_conditions
except_provided_paragraph__1
locations_duration_order__1
locations_duration_order__2
locations_duration_order__3
fill__20
fill__21
fill__22
fill__23
except_provided_paragraph__2
unknown__2
custody_minor_children
unknown__3
fill__24
f_thi_paragrap_h__1
f_thi_paragrap_h__2
f_thi_paragrap_h__3
1_2
2_2
partial_custody_visitation__1
partial_custody_visitation__2
partial_custody_visitation__3
fill__25
fill__26
fill__27
current_custody_order
children_parties__1
children_parties__2
fill__28
fill__29
toggle__25
custody_petition_pending
undefined__2
toggle__26
toggle__27
hearing_scheduled
fill__30
thi_orde_r_shal_l_supersed_e
toggle__28
toggle__29
thi_orde_r_supersede_prior__1
firearm_r_weapon_ammunition
unknown__4
defendant_acquiring
toggle__30
toggle__31
defendant_shall_sheriff
licenses_possessed_defendant__1
licenses_possessed_defendant__2
licenses_possessed_defendant__3
fill__31
fill__32
fill__33
toggle__32
defendant_relinquish_sheriff
firearm_delivered_sheriff_appropriate
pennsylvania_state_municipal
additional_granted_authorized
pay_temporary_support
undefined__3
defendant_prohibited_stalking
toggle__33
relief
undefined__4
fill__34
fill__35
fill__36
fill__37
fill__38
1_3
2_3
follows__1
follows__2
follows__3
fill__39
fill__40
fill__41
unknown__5
undefined__5
defendant_shall_pay
thi_orde_r_supersede_prior__2
provisions_order_expire
b_order_followed_contested
plaintiff_granted_petition
toggle__34
toggle__35
toggle__36
toggle__37
upon_showing_good_cause_finding
compensation_plaintiffs
fill__42
unknown__6
toggle__38
appropriate_notice_defendant__1
appropriate_notice_defendant__2
in
days_months_years
signature_date__1
toggle__39
three_years
toggle__40
signature_date__2
fill__43
the
fill__44
fill__45
fill__46
attorney_plaintiffs_signature
attorney_defendants_signature
text__8
users1_signature

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

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