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

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Here is the text we could read:

Commonwealth of Pennsylvania 
Court of Common Pleas 
County of:      

 Judicial District 

Appellant Name:

Address:

City:

Date:

Citation No: 

Issuing Authority Docket 
Number:

State:

Zip:

Magisterial District No:

Notice of Appeal from Summary 
Criminal Conviction 

A sentence of                    was imposed on:                        .  Offense(s) of which convicted: 

Grounds relied upon for appeal (except when the appeal is from a guilty plea or a conviction): 

Date of entry of guilty plea, the conviction, or other final order from which appeal is taken: 

Name and mailing address of affiant as show on 
citation or complaint: 

If sentence includes fines, costs or restitution, 
amount paid, if any: 

Type or amount of bail or collateral furnished to 
issuing authority, if any: 

Affiant Name:

Address:

City:

Issuing Authority:

Address:

City:

Phone No:

State:

Zip:

State:

Zip:

Name and mailing address of issuing authority: 

Name and address of attorney filing notice of appeal: 

Attorney Signature:

Attorney Name (Printed):

Address:

City:

Phone No:

Supreme Court ID Number:

State:
         

 Fax No: 

Zip: 

NOTICE TO DEFENDANT: 

If your appeal is from a motor vehicle conviction other than parking, have the clerk of courts certify this copy and 
mail to the following address: 

PennDOT
Correspondence Unit
PO Box 68618
Harrisburg, PA 17106 

I hereby certify that an appeal has been filed in the above-captioned case. 

Clerk of Courts 

AOPC 2026

Commonwealth of Pennsylvania

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): 1
Fields(s): 40
Average fields per page: 40
Reading Level: Grade 9
LIST Grouping(s): CO-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.

appellant_name was AppellantName (0.66 conf)
appellant_address was AppellantAddress (0.39 conf)
appellant_city was AppellantCity (0.46 conf)
appellant_state was AppellantState (0.49 conf)
appellant_zip was AppellantZip (0.37 conf)
signature_date was Date (1.00 conf)
docket_num was DocketNum (0.33 conf)
citation_num was CitationNum (0.41 conf)
mag_district_num was MagDistrictNum (0.29 conf)
affiant_name was AffiantName (0.43 conf)
affiant_address was AffiantAddress (0.36 conf)
issuing_authority was IssuingAuthority (0.42 conf)
issuing_auth_addr was IssuingAuthAddr (0.35 conf)
issuing_auth_ph was IssuingAuthPh (0.45 conf)
fines_costs was FinesAndCosts (0.38 conf)
bail_collateral was BailOrCollateral (0.44 conf)
attorney_signature was AttorneySignature (0.46 conf)
attorney_print_name was AttorneyPrintName (0.47 conf)
affiant_city was AffiantCity (0.32 conf)
affiant_state was AffiantState (0.46 conf)
affiant_zip was AffiantZip (0.33 conf)
atty_city was AttyCity (0.33 conf)
atty_state was AttyState (0.41 conf)
atty_zip was AttyZip (0.36 conf)
atty_ph was AttyPh (0.38 conf)
atty_fax was AttyFax (0.40 conf)
sup_ct_id_num was SupCtIDNum (0.35 conf)
county was CountyOf (0.41 conf)
jud_dist was JudDist (0.42 conf)
sentence was SentenceOf (0.46 conf)
offense was Offense (0.28 conf)
grounds_appeal was GroundsForAppeal (0.37 conf)
date_entry was DateOfEntry (0.41 conf)
issuing_auth_city was IssuingAuthCity (0.37 conf)
issuing_auth_state was IssuingAuthState (0.43 conf)
issuing_auth_zip was IssuingAuthZip (0.33 conf)
imposed was ImposedOn (0.46 conf)
clerk_courts_sig was ClerkOfCourtsSig (0.45 conf)
atty_addr__1 was AttyAddr (0.38 conf)
atty_addr__2 was AttyAddr2 (0.36 conf)

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

Commonwealth of Pennsylvania

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