MAGISTERIAL DISTRICT COURT No. _________, of 
______________ COUNTY, PENNSYLVANIA 
tulakarDI®sÞIkemCIsþWerolelx _________, én 
exanFI ______________ epnsuIlva:eno 

OCKET NO:       _____________________ 
sMNuMerOgelx  

ATE FILED:       _____________________ 
kalbriecäTdak;bNþwg  
 

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                               esckþIbgÁab;  
hIy\LÚvenH éf¶TI ____ Ex ______ qñaM___________  
RtUv)anbgÁab; nigRbkasfa  esckþIbgÁab;karBar RtUv)ancUlCa 
FrmanenAeRkam 18 Pa.C.S. §4954 edaytMNag[ 
_____________________________ . 
amry³enH RtUv)anbgÁab;fa cugecaT  ______________ 
_________________________ RtUvQb;TMnak;TMng b¤ 
KRmamkMEhgbuKÁlEdlmaneQµaHdUcerobrab;xagelIedaypÞal; 
b¤tamry³RKYsar b¤mitþPkþi ehIyfa cugecaTminRtUvman 
TMnak;TMngNamYyCamYynwgsakSI EdlmaneQµaHdUcerobrab; 
xagelIeLIy elIkElgEttamry³emFavI . 
arbMBaneTAelIesckþIbgÁab;enH nwgRtUvTTYleTasBin½yeday 
sßiteRkam 18 Pa.C.S. §4955 . 

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       1. GñkGacRtUv)ancab;xøÚn BIbTKRmamkMEhgsakSI  
EdlCakarecaTRbkan;BIbT]RkidækRmitF¶n; . 

       2. GñkGacRtUv)anecaTRbkan;fa mineKarBtamtulakar . 

       3. eTasBin½yTaMgenH GacRtUv)anecaTRbkan; 
minfaEtkarbMBanEdlRtUv)anbwþgenH RtUv)anRbRBwtþieLIgedayxøÜn  
 
ñkpÞal; b¤Gñk)anbgá b¤CRmuj[mankarbMBanenHekItmaneLIg 
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  BY THE COURT: 
enaHeLIy .  
  edaytulakar 
 

Commonwealth of Pennsylvania  

Ilv:aeno 

  xum:unEvlGhVepnsu
             v.    
           Tl;nwg 
 

________________________________ 

                     

                     Order  
                         

   AND NOW, this ____ day of ____________, 
______, it is  

ORDERED AND DECREED that  
a PROTECTIVE ORDER is entered under 18 
Pa.C.S. §4954 on behalf of 
_____________________________. 

T IS HEREBY ORDERED that the defendant, 
_________________________, refrain from 
contacting or intimidating the above mentioned 
person(s) either personally or by family or friends, 
and that the defendant have no communication 
whatsoever with the witnesses above-named except 
through an attorney. 

iolation of this ORDER carries the following 

penalties under 18 Pa.C.S. §4955. 

   

   

   

       1. You may be arrested for intimidation against 
a witness, a felony charge. 

       2. You may be held in contempt of Court. 

       3. These penalties may be imposed whether the 
violation complained of has been committed by you 
personally or you caused or encouraged the violation 
to be committed.   

                            

 
 

 
 

 
 
 

 
 
 

 
 
 

     

  

   

 
 
 

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________________________________                    _____________________________________    
Date                              
kalbriecäT                          

              President Judge  
         RbFanecARkm  

 
 

 

AOPC 3521 REV. 09/03/2008-Khmer/Cambodian  

 

   [Quantum 2009]