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

LIT Lab Home | About The Explorer | Find & Compare | Explore: Pennsylvania Lists

Here is the text we could read:

IN THE COURT OF COMMON PLEAS OF ______________ COUNTY

В СУДЕ ОБЩЕГРАЖДАНСКИХ ИСКОВ ОКРУГА ____________________

PLAINTIFF / ИСТЕЦ

___________________________

VS.

CASE NO. / ДЕЛО №
__________________

DEFENDANT / ОТВЕТЧИКА

PROTECTION FROM ABUSE /

ЗАЩИТА ОТ ЖЕСТОКОГО ОБРАЩЕНИЯ

___________________________

PETITION FOR PROTECTION OF
VICTIMS OF
SEXUAL VIOLENCE
SEXUAL VIOLENCE AGAINST A
MINOR CHILD
INTIMIDATION

ХОДАТАЙСТВО О ЗАЩИТЕ ЖЕРТВ

ПОЛОВОГО НАСИЛИЯ
ПОЛОВОГО НАСИЛИЯ НАД
НЕСОВЕРШЕННОЛЕТНИМ
РЕБЕНКОМ
ЗАПУГИВАНИЯ

Plaintiff:

1.
__________________________________
First

Last Name

Middle

Истец:

1.
__________________________________
Имя

Отчество

Фамилия

Plaintiff’s Address: _________________

Адрес: ____________________________

Plaintiff’s  address 
pursuant to 42 Pa.C.S. § 62A11.

is  confidential

Адрес истца является

конфиденциальной информацией
согласно 42 Pa.C.S. § 62A11.

Plaintiff’s Date of Birth: _______________

Дата рождения: ____________________

I am filing this petition on behalf of

Я  ходатайствую

от своего  имени  или

myself or

another person.

от имени другого лица.

If you checked “myself,” please answer all
questions referring to yourself as “Plaintiff.”
If you checked “another person,” please
answer all questions referring to that
person as “Plaintiff,” and provide your
name and address below.

Если вы отметили «от своего имени»,
ответьте на все вопросы, подразумевая
под истцом себя. Если вы отметили «от
имени другого лица», ответьте на все
вопросы, называя такое лицо истцом, и
укажите ниже свои Ф. И. О. и адрес.

AOPC PSVI (Russian)

Created: December 26, 2016

Name: ____________________________

Ф. И. О.: __________________________

Address: __________________________

Адрес: __________________________

If  you  checked  “another  person,”  indicate
your relationship to the plaintiff:

__________________________________

Если  вы  отметили  «от  имени  другого
лица»,  укажите,  кем  вы  приходитесь
истцу:
__________________________________

2.

Defendant:

2.

Ответчик:

________________________________
First

Last Name

Middle

________________________________
Имя

Отчество

Фамилия

Defendant’s Address:
________________________________
________________________________

Адрес:
________________________________
________________________________

DEFENDANT IDENTIFIERS

ЛИЧНЫЕ СВЕДЕНИЯ И ВНЕШНИЕ ПРИЗНАКИ
ОТВЕТЧИКА

HEIGHT

WEIGHT

EYES

РОСТ

ВЕС

ЦВЕТ ГЛАЗ

ДАТА РОЖДЕНИЯ

ПОЛ

РАСОВАЯ
ПРИНАДЛЕЖНОСТЬ

ЦВЕТ ВОЛОС

КАРТОЧКА СОЦ.
ОБЕСПЕЧЕНИЯ №

ВОДИТЕЛЬСКОЕ
УДОСТОВЕРЕНИЕ

ЕЙСТВИТЕЛЬНО

№ Д

ДО

DOB

SEX

RACE

HAIR

SSN

DRIVERS
LICENSE #

EXP DATE

STATE

ШТАТ

of 

other 

Name(s) 

3.
designated
person(s) under 42 Pa.C.S. § 62A07(b)(1):
__________________________________
__________________________________

Ф.  И.  О.  других  указанных  лиц

3.
согласно 42 Pa.C.S. § 62A07(b)(1):
__________________________________
__________________________________

4.
Is there a relationship between
Plaintiff and Defendant? ________.   If
yes, what is the relationship?
__________________________________
__________________________________

4.
Существуют ли отношения между
истцом и ответчиком? ________.   Если
«да», какие между ними отношения?
__________________________________
__________________________________

AOPC PSVI (Russian)

Created: December 26, 2016

Have Plaintiff and Defendant been

5.
involved in any other legal proceedings?  If
so, state when and where the case was
filed and the court docket number, if
known:
__________________________________
__________________________________
__________________________________
__________________________________

Участвуют ли истец и ответчик в

5.
других судебных процессах?  Если
«да», укажите дату открытия дела, суд и
номер дела (при наличии):

__________________________________
__________________________________
__________________________________
__________________________________

Has Defendant been involved in

6.
any criminal proceedings?
__________________________________
__________________________________

Является ли ответчик участником

6.
каких-либо уголовных процессов?
__________________________________
__________________________________

If you answered Yes, is Defendant
currently on probation or parole?

__________________________________
__________________________________

Если вы ответили «да», находится ли
ответчик в настоящее время на
условном или досрочном
освобождении?
__________________________________
__________________________________

(a)

The facts of the most recent
7.
incident of sexual violence are as follows:

(a)

7.
последнего случая полового насилия:

Обстоятельства

Approximate Date:
__________________________________

Примерная дата:
__________________________________

Approximate Time:
__________________________________

Примерное время:
__________________________________

Place:
__________________________________

Место:
__________________________________

AOPC PSVI (Russian)

Created: December 26, 2016

Describe in detail what happened,
including any physical or sexual abuse,
threats, injury, incidents of stalking,
medical treatment sought, and/or calls to
law enforcement (attach additional sheets
of paper if necessary):

__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

Подробно опишите случившееся, в том
числе физическое насилие,
принуждение к действиям сексуального
характера, угрозы, травмы, случаи
преследования, обращение за
медицинской помощью, а также звонки
в правоохранительные органы (при
необходимости приложите
дополнительные листы):
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

(b)

The facts of the most recent

(b)

Обстоятельства

incident of intimidation are as follows:

последнего случая запугивания:

Approximate Date:
__________________________________

Примерная дата:
__________________________________

Approximate Time:
__________________________________

Примерное время:
__________________________________

Place:
__________________________________

Место:
__________________________________

Describe in detail what happened,
including medical treatment sought, and/or
calls to law enforcement (attach additional
sheets of paper if necessary):

__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

Подробно опишите случившееся, в том
числе обращение за медицинской
помощью и звонки в
правоохранительные органы (при
необходимости приложите
дополнительные листы):
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

AOPC PSVI (Russian)

Created: December 26, 2016

If Defendant has committed prior

8.
acts of sexual violence or intimidation
against Plaintiff, describe these prior
incidents, and indicate approximately
when such acts occurred (attach additional
sheets of paper if necessary):

__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

Если ответчик ранее совершал

8.
акты полового насилия или запугивания
в отношении истца, опишите эти
инциденты и укажите приблизительно,
когда они происходили (при
необходимости приложите
дополнительные листы):
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

9.
Identify the sheriff, police
department, or other law enforcement
agency in the area in which Plaintiff lives
that should be provided with a copy of the
protection order:
__________________________________
__________________________________

Укажите имя шерифа, отделение

9.
полиции или другой
правоохранительный орган в районе
проживания истца, которым следует
предоставить копию охранного приказа:
__________________________________
__________________________________

Is Plaintiff in immediate and present

10.
danger from Defendant?  If so, please
describe:

__________________________________
__________________________________

В настоящее время существует

10.
ли прямая и непосредственная
опасность для истца со стороны
ответчика? Если «да», опишите:
__________________________________
__________________________________

FOR THE REASONS SET FORTH
ABOVE, I REQUEST THAT THE COURT
ENTER A TEMPORARY ORDER AND,
AFTER A HEARING, A FINAL ORDER
THAT WOULD INCLUDE ALL OF THE
FOLLOWING RELIEF (CHECK ALL
FORMS OF RELIEF REQUESTED):

ПО ВЫШЕУКАЗАННЫМ ПРИЧИНАМ Я
ХОДАТАЙСТВУЮ О ТОМ, ЧТОБЫ СУД
ВЫДАЛ ВРЕМЕННЫЙ ПРИКАЗ И,
ПОСЛЕ ПРОВЕДЕНИЯ СЛУШАНИЯ,
ОКОНЧАТЕЛЬНЫЙ ПРИКАЗ О
СЛЕДУЮЩЕМ (ОТМЕТЬТЕ ВСЕ
ЗАПРАШИВАЕМЫЕ СРЕДСТВА
СУДЕБНОЙ ЗАЩИТЫ):

A. Restrain Defendant from having any

A. Запретить ответчику вступать в

contact with the victim, including, but not
limited to, entering the victim’s residence,
place of employment, business, or school.

любой контакт с жертвой, включая, в
том числе, появление в месте
жительства, работы или обучения
жертвы.

AOPC PSVI (Russian)

Created: December 26, 2016

B. Prohibit indirect contact through

B. Запретить косвенный контакт

third parties.

через третьих лиц.

C. Prohibit direct or indirect contact

with other designated persons.

C. Запретить прямой и косвенный
контакт с другими указанными лицами.

D. Order Defendant to pay the fees of

D. Дать указание ответчику оплатить

this action.

судебные издержки по данному делу.

E. Order the following additional relief,

E. Присудить иные, не указанные

not listed above:
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

выше средства судебной защиты:
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

F. Grant such other relief as the court

F. Присудить другие средства

deems appropriate, including, but not
limited to, issuing an order under 42
Pa.C.S. § 62A11(b) related to the
nondisclosure of the victim's address,
telephone number, whereabouts or other
demographic information.

судебной защиты по усмотрению суда,
включая, в том числе, выдачу приказа,
согласно 42 Pa.C.S. § 62A11(b), о
запрете на разглашение адреса,
телефона, местонахождения и других
демографических данных жертвы.

G. Order the police, sheriff or other law

enforcement agency to serve the
Defendant with a copy of this petition, any
order issued, and the order for the hearing.
Plaintiff will inform the designated authority
of any addresses, other than Defendant’s
residence, where Defendant can be
served.

G. Дать указание полиции, шерифу
или иному правоохранительному органу
вручить ответчику копию настоящего
ходатайства, выданного приказа и
приказа о проведении слушания.  Истец
уведомит указанную организацию обо
всех адресах, помимо места
проживания ответчика, где ответчику
можно вручить документы.

AOPC PSVI (Russian)

Created: December 26, 2016

VERIFICATION

УДОСТОВЕРЕНИЕ

I verify that the statements made in
this petition are true and correct to the best
of my knowledge. I understand that false
statements herein are made subject to the
penalties of 18 Pa.C.S. § 4904, relating to
unsworn falsification to authorities.

Я удостоверяю, что по

имеющимся у меня сведениям
заявления в настоящем ходатайстве
являются подлинными и верными. Я
понимаю, что предоставление ложных
сведений карается наказанием согласно
18 Pa.C.S. § 4904 касательно ложных
свидетельств, сделанных не под
присягой для государственных органов.

_____________________________________________________________________
Signature / Подпись

_____________________________________________________________________
Date / Дата

AOPC PSVI (Russian)

Created: December 26, 2016

Russian Notice of Hearing and Order Petition Temporary Order Affidavit of Service and the Final Order

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): 7
Fields(s): 169
Average fields per page: 24
Reading Level: Grade 7
LIST Grouping(s): GO-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.

n_th_e_cour_f_commo_plea was IN THE COURT OF COMMON PLEAS OF_2 (0.57 conf)
count was COUNTY_2 (0.37 conf)
fill__1 was fill_4_2 (0.40 conf)
fill__2 was fill_5_3 (0.40 conf)
fill__3 was fill_3_2 (0.40 conf)
check_box__1 was Check Box6 (0.37 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 Box7 (0.37 conf)
check_box__7 was Check Box8 (0.37 conf)
check_box__8 was Check Box9 (0.37 conf)
unknown__1 was 1 (0.38 conf)
1_2 was 1_2 (0.38 conf)
middle was Middle (0.31 conf)
fill__4 was fill_9 (0.36 conf)
plaintiffs_date_birth was Plaintiffs Date of Birth (0.44 conf)
fill__5 was fill_11_2 (0.40 conf)
check_box__9 was Check Box10 (0.37 conf)
check_box__10 was Check Box11 (0.37 conf)
check_box__11 was Check Box12 (0.37 conf)
check_box__12 was Check Box13 (0.37 conf)
users1_name was Name (1.00 conf)
undefined was undefined (0.38 conf)
users1_address_line_one was Address (1.00 conf)
fill__6 was fill_4_3 (0.40 conf)
relationship_plaintiff was your relationship to the plaintiff (0.45 conf)
fill__7 was fill_6_2 (0.40 conf)
unknown__2 was 2 (0.38 conf)
2_2 was 2_2 (0.38 conf)
defendants_address__1 was Defendants Address 1 (0.31 conf)
defendants_address__2 was Defendants Address 2 (0.31 conf)
fill__8 was fill_10 (0.36 conf)
fill__9 was fill_12 (0.36 conf)
users1_birthdate was DOB (1.00 conf)
height was HEIGHT (0.36 conf)
fill__10 was fill_25 (0.36 conf)
fill__11 was fill_26 (0.36 conf)
sex was SEX (0.38 conf)
weight was WEIGHT (0.36 conf)
fill__12 was fill_27 (0.36 conf)
fill__13 was fill_28 (0.36 conf)
race was RACE (0.41 conf)
eyes was EYES (0.34 conf)
fill__14 was fill_31 (0.36 conf)
fill__15 was fill_32 (0.36 conf)
hair was HAIR (0.34 conf)
fill__16 was fill_36 (0.36 conf)
ssn was SSN (0.34 conf)
fill__17 was fill_38 (0.37 conf)
driver_license was DRIVERS LICENSE (0.46 conf)
fill__18 was fill_39 (0.37 conf)
ex_p_date was EXP DATE (0.32 conf)
users1_address_state was STATE (1.00 conf)
fill__19 was fill_41 (0.37 conf)
fill__20 was fill_42 (0.37 conf)
persons_pa_c_b__1 was persons under 42 PaCS 62A07b1 1 (0.33 conf)
persons_pa_c_b__2 was persons under 42 PaCS 62A07b1 2 (0.33 conf)
fill__21 was fill_13_2 (0.40 conf)
fill__22 was fill_15_2 (0.40 conf)
relationship was Is there a relationship between (0.41 conf)
fill__23 was fill_17_2 (0.40 conf)
yes_relationship__1 was yes what is the relationship 1 (0.43 conf)
yes_relationship__2 was yes what is the relationship 2 (0.43 conf)
fill__24 was fill_19 (0.36 conf)
fill__25 was fill_21 (0.36 conf)
known__1 was known 1 (0.42 conf)
known__2 was known 2 (0.42 conf)
known__3 was known 3 (0.42 conf)
known__4 was known 4 (0.42 conf)
fill__26 was fill_2 (0.36 conf)
fill__27 was fill_4_4 (0.40 conf)
fill__28 was fill_6_3 (0.40 conf)
fill__29 was fill_8 (0.36 conf)
criminal_proceedings__1 was any criminal proceedings 1 (0.43 conf)
criminal_proceedings__2 was any criminal proceedings 2 (0.43 conf)
fill__30 was fill_10_2 (0.40 conf)
fill__31 was fill_12_2 (0.40 conf)
1_3 was 1_3 (0.38 conf)
2_3 was 2_3 (0.38 conf)
fill__32 was fill_14 (0.36 conf)
fill__33 was fill_16 (0.36 conf)
approximate_date__1 was Approximate Date (0.34 conf)
fill__34 was fill_18 (0.36 conf)
approximate_time__1 was Approximate Time (0.34 conf)
fill__35 was fill_20 (0.36 conf)
place__1 was Place (0.32 conf)
fill__36 was fill_22 (0.36 conf)
1_4 was 1_4 (0.38 conf)
2_4 was 2_4 (0.38 conf)
unknown__3 was 3 (0.38 conf)
unknown__4 was 4 (0.38 conf)
unknown__5 was 5 (0.38 conf)
unknown__6 was 6 (0.38 conf)
fill__37 was fill_2_2 (0.40 conf)
fill__38 was fill_4_5 (0.40 conf)
fill__39 was fill_6_4 (0.40 conf)
fill__40 was fill_8_2 (0.40 conf)
fill__41 was fill_10_3 (0.40 conf)
fill__42 was fill_12_3 (0.40 conf)
approximate_date__2 was Approximate Date_2 (0.36 conf)
fill__43 was fill_14_2 (0.40 conf)
approximate_time__2 was Approximate Time_2 (0.30 conf)
fill__44 was fill_16_2 (0.40 conf)
place__2 was Place_2 (0.39 conf)
fill__45 was fill_18_2 (0.40 conf)
1_5 was 1_5 (0.38 conf)
2_5 was 2_5 (0.38 conf)
3_2 was 3_2 (0.38 conf)
4_2 was 4_2 (0.38 conf)
5_2 was 5_2 (0.38 conf)
6_2 was 6_2 (0.38 conf)
fill__46 was fill_20_2 (0.40 conf)
fill__47 was fill_22_2 (0.40 conf)
fill__48 was fill_24 (0.36 conf)
fill__49 was fill_26_2 (0.40 conf)
fill__50 was fill_28_2 (0.40 conf)
fill__51 was fill_30 (0.36 conf)
sheets_paper_necessary__1 was sheets of paper if necessary 1 (0.31 conf)
sheets_paper_necessary__2 was sheets of paper if necessary 2 (0.31 conf)
sheets_paper_necessary__3 was sheets of paper if necessary 3 (0.31 conf)
sheets_paper_necessary__4 was sheets of paper if necessary 4 (0.31 conf)
sheets_paper_necessary__5 was sheets of paper if necessary 5 (0.31 conf)
sheets_paper_necessary__6 was sheets of paper if necessary 6 (0.31 conf)
fill__52 was fill_2_3 (0.40 conf)
fill__53 was fill_4_6 (0.40 conf)
fill__54 was fill_6_5 (0.40 conf)
fill__55 was fill_8_3 (0.40 conf)
fill__56 was fill_10_4 (0.40 conf)
fill__57 was fill_12_4 (0.40 conf)
protection_order__1 was protection order 1 (0.34 conf)
protection_order__2 was protection order 2 (0.34 conf)
fill__58 was fill_14_3 (0.40 conf)
fill__59 was fill_16_3 (0.40 conf)
describe__1 was describe 1 (0.45 conf)
describe__2 was describe 2 (0.45 conf)
fill__60 was fill_18_3 (0.40 conf)
fill__61 was fill_20_3 (0.40 conf)
check_box__13 was Check Box14 (0.37 conf)
check_box__14 was Check Box15 (0.37 conf)
check_box__15 was Check Box16 (0.37 conf)
check_box__16 was Check Box17 (0.37 conf)
check_box__17 was Check Box18 (0.37 conf)
check_box__18 was Check Box19 (0.37 conf)
check_box__19 was Check Box20 (0.37 conf)
check_box__20 was Check Box21 (0.37 conf)
check_box__21 was Check Box22 (0.37 conf)
check_box__22 was Check Box23 (0.37 conf)
listed__1 was not listed above 1 (0.36 conf)
listed__2 was not listed above 2 (0.36 conf)
listed__3 was not listed above 3 (0.36 conf)
listed__4 was not listed above 4 (0.36 conf)
listed__5 was not listed above 5 (0.36 conf)
listed__6 was not listed above 6 (0.36 conf)
listed__7 was not listed above 7 (0.36 conf)
fill__62 was fill_2_4 (0.40 conf)
fill__63 was fill_4_7 (0.40 conf)
fill__64 was fill_6_6 (0.40 conf)
fill__65 was fill_8_4 (0.40 conf)
fill__66 was fill_10_5 (0.40 conf)
fill__67 was fill_12_5 (0.40 conf)
fill__68 was fill_14_4 (0.40 conf)
check_box__23 was Check Box24 (0.37 conf)
check_box__24 was Check Box25 (0.37 conf)
check_box__25 was Check Box26 (0.37 conf)
check_box__26 was Check Box27 (0.37 conf)
fill__69 was fill_1 (0.36 conf)
fill__70 was fill_2_5 (0.40 conf)

Create an Interactive Version of this Form:

The Weaver creates a draft guided interview from a template form, like the one provided here. You can use the link below to open this form in the Weaver. To learn more, read "Weaving" your form into a draft interview.

Launch Form in Weaver

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

Russian Notice of Hearing and Order Petition Temporary Order Affidavit of Service and the Final Order

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

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