REQUEST FOR ORDER FOR 
POSSESSION  
DEMANN POU LÒD POU POSESYON  
 

 

___________________________________ 
V. / Kont 
 

___________________________________ 
 

   

 

Docket No/Nimewo Lis Dosye: 

Case Filed/Ka a Ranpli: 

Time Filed/Lè yo Depoze li: 

Date Order Filed/ 
Dat yo depoze Lòd la: 

COMMONWEALTH OF PENNSYLVANIA  

COUNTY OF 

KOMINOTE PENNSYLVANIA  

KONTE 
 

Mag. Dist. No: 
Nimewo Distri Majistral 
MDJ Name: 
Non Jij Distri Majistral la: 

ddress: 

Adrès: 

elephone: 

Telefòn: 

  A

    T

         

Judgment Amount 
Montan Jijman an  $_______________ 

Costs in Original LT Proceeding 
Pri nan Pwosè Orijinal 

pwopriyetè/lokatè a  $_______________ 

Costs in this Proceeding 

Pri nan Pwosè sa a  $_______________ 

Attorney Fees 

Frè Avoka  $_______________ 

Total 
Total 

$_______________ 

   

    M

    M

   

TO THE MAGISTERIAL DISTRICT JUDGE: 
The Landlord(s) named below, having obtained a judgment 
for possession of real property located at: 
 

POU JIJ DISTRI MAJISTRAL LA: 
Mèt kay la (yo) ki endike anba la a, apre yo te resevwa yon 
jijman pou posesyon byen imobilye ki sitiye nan: 

Requests that you issue an ORDER FOR POSSESSION for 
such property. 
 

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. 
 

ande pou w bay yon LÒD POU POSESYON pou 

pwopriyete sa a. 

wen sètifye demann mwen depoze sa a konfòme ak 

dispozisyon Politik Aksè Piblik nan Dosye Ka Sistèm 
Jidisyè Inifye Pennsylvania a ki egzije yo depoze 
enfòmasyon konfidansyèl yon fason diferan ak fason yo 
depoze dokiman ak enfòmasyon ki pa konfidansyèl yo. 

 

 

 

 

 

 

 

 

 

 

Landlord Signature/Siyati Mèt Kay la:      

   

Landlord/Mèt Kay:     

 

 

 

Date/Dat:      

AOPC 311A 

1 

FREE INTERPRETER 
ENTÈPRÈT GRATIS 
www.pacourts.us/language-rights 

Address if any: 

Adrès si genyen: