REQUEST FOR CORRECTION OF AN ELECTRONIC CASE RECORD 
(A separate request form must be submitted for each case) 

Requestor Information 

Name: 

Address: 

Attorney No. (if applicable): 

Phone Number: 

Email Address: 

Fax Number:

Case caption of the electronic case record: 

Docket number of the electronic case record: 

_____________________________________________________________________________________________ 

Set forth in specificity the information that appears on the electronic case record referenced above which 
you believe to be in error.  (Attach additional sheets if necessary). 

Set forth in specificity sufficient facts that support your contention that the information in question is in 
error, including supporting documentation.  (Attach additional sheets if necessary). 

I, _________________________________, verify that the facts set forth in this form are true and correct to the 
best of my knowledge, information and belief.  This statement is made subject to the penalties of Section 4904 
of the Crimes Code (18 Pa.C.S. § 4904) relating to unsworn falsification to authorities. 

___________________________________
 Signature of Requestor 

_______________________________
Date

NOTE:  If you are seeking to correct a data error in an electronic case record of a court of common pleas or 
Philadelphia Municipal Court (i.e., a CPCMS record), this form must be submitted to the appropriate clerk of 
courts. If you are seeking to correct the data error in an electronic record of a magisterial district court 
(i.e., a MDJS record), this form must be filed with the magisterial district court presiding over the case. You 
must also provide a copy of this completed form to all parties on the case, the appropriate district court 
administrator and AOPC. Addresses for district court administrators, clerk of courts and magisterial district 
judges may be found on the UJS Web site under the "Electronic Case Record" section at: 
http://www.pacourts.us/T/AOPC/PublicAccessPolicy.htm. 
Copies to the AOPC should be sent to:

Administrative Office of Pennsylvania Courts
ATTN: Section 6.00 Request
601 Commonwealth Avenue 
PO Box 61260
Harrisburg, PA 17106-1260
Phone: 717-231-3300
Fax: 717-231-9566

For Court Use Only 

Please be advised that your request was received on ______________.  In accordance with the Electronic 
Case Record Public Access Policy of the Unified Judicial System, please be advised that: 

This request is being returned to you because it does not contain sufficient information to evaluate 
your request.  No further action will be taken unless you resubmit the request with additional information. 

This request is being returned to you because it does not concern an electronic case record.  No 

further action will be taken on this matter. 

It was determined an error existed in the electronic case record, and the information has been 

It was determined an error does not exist in the electronic case record. 

An additional period of time not exceeding 30 business days is necessary to complete a review of 

corrected. 

your request.   

Comments: 

______________________________________
Signature

________________________________
Date

If an additional period of time not exceeding 30 days was necessary to complete the review of this request, 
please be advised that: 

this request is being returned to you because it does not contain sufficient information to evaluate 

your request.  No further action will be taken unless you resubmit the request with additional information. 

this request is being returned to you because it does not concern an electronic case record.  No 

further action will be taken on this matter. 

it was determined an error existed in the electronic case record, and the information has been 

corrected. 

Comments: 

it was determined an error does not exist in the electronic case record. 

__________________________________
Signature

________________________________
Date

For Use by Requestor 

If you wish to seek review of the decision set forth above, please complete this section and submit this entire 
form to the District Court Administrator of the county where the electronic case record information 
originated within 10 business days of notification of the decision. 

I,_________________________________, request that a review of the decision set forth above be made. 

__________________________________
Signature

________________________________
Date