Here is the text we could read:
P
IN THE COURT OF COMMON PLEAS OF _________________________ COUNTY
ក
ងតុលករ
ន
ន
ក
ងតុលករ
ងតុលករ
ន
ក
ងតុលករ
ន
ក
ុ
ុ
ុ
ុ
_________________________
បណតឹងបណតឹងបណតឹងបណតឹងទូេទទូេទទូេទទូេទៃនៃនៃនៃនេខនធី
ខនធី
េ
េ
ខនធី
េ
ខនធី
_____________________________________________
PLAINTIFF / េដមបណតឹង
េដមបណតឹង
េដមបណតឹង
េដមបណតឹង
V. / ទល់នឹងទល់នឹងទល់នឹងទល់នឹង
FAMILY COURT DIVISION
ត
លកររគួសរ
ុ
ុ
ត
លកររគួសរ
លកររគួសរ
ុ
ត
លកររគួសរ
ុ
ត
CIVIL ACTION
បណតឹងសុីវលិិិិ
បណតឹងសុីវល
បណតឹងសុីវល
បណតឹងសុីវល
No. / េលខេលខេលខេលខ
________________________________
_____________________________________________
DEFENDANT / ចុងេចទចុងេចទចុងេចទចុងេចទ
ROTECTION FROM ABUSE
ករករពរពីកររំេលភបំពនបំពនបំពនបំពន
ករករពរពីកររំេលភ
ករករពរពីកររំេលភ
ករករពរពីកររំេលភ
AFFIDAVIT OF SERVICE
តលិខិតលិខិតលិខិតរបកសរបកសរបកសរបកសសតីសតីសតីសតីពីករពីករពីករពីករបញជនបញជនបញជនបញជនូូូូ ពកយពកយពកយពកយបណតឹងបណតឹងបណតឹងបណតឹង
ល
ិ
ខ
ិ
I, _____________________________, the undersigned,
hereby state that I served a copy of the Notice of Hearing and
Order, Petition and Temporary Order in the above captioned
action upon Defendant by handing the papers to:
________________________________________________
at the following address:
________________________________________________,
__________________, Pennsylvania, ON THE ______ DAY
OF _____________________________, 20_____________
AT APPROXIMATELY __________ A.M. / P.M.
I verify that the statements made in this Affidavit are true and
correct. I understand that false statements are made subject to
the penalties of 18 Pa.C.S. §4904, relating to unsworn
falsification to authorities.
_____________________________ជហតថេលខី សូមបញជ ក់ថ ខញ
ខញ
ុបន
ជូនដណឹ ងពីសវនករ
និងដកី
ពកយ
បញជ នូ ចបប់ចមលងៃនេសចកត
បណត
ឹ ង និងដកី បេណត ះអសនន កនងុ នីតិវធី
ិ បណត
ឹ ងខងេលេទឲយ
ចុងេចទ េដយរបគល់ឯកសរឲយ:
_______________________________________________
េនអសយដឋ នដូចខងេរកមៈ
______________________________________________,
លវ៉ េនៀ េនៃថងទី
_______________________, រដឋេផនសុ
___________________________, 20_____________
េនេវលេម៉ ងរបែហល __________ រពឹក/លង ច។
ខង
ំបញជ ក់ថ
េសចកត
ីែថលងករណ៍ ែដលបនេធវ
េឡងកនងុ លិខិតរបកស
ដងឹ ថ េសចកត
េនះ ជករពិត និងរតឹមរតូវ។ ខញ
នឹងរតូវទទួលទណឌ កមមេរកម 18 Pa.C.S. §4904,
ំយល់
ែថលងករណ៍ មិនពិត
ទក់ទិននឹងករែកលងបនល
ចំេពះមុខអជញ ធរ។
_______________________________________________
Signature /ហតថេលខ
_______________________________________________
Address /
អសយដឋន
Date / កលបរិេចឆទៈ
____________________________________
HIS FORM MUST BE COMPLETED AND SIGNED BY THE PERSON WHO SERVES THE DEFENDANT WITH
THE NOTICE OF HEARING AND ORDER, PETITION AND TEMPORARY ORDER. IT MUST BE BROUGHT TO
COURT ON THE HEARING DATE.
ទរមង់េនះរតូវបំេពញ និងចុះហតថេលខេដយជនែដលបញជនូ េសចកតីជូនដណឹងពីសវ
បេណត ះអសននេទឲយចុងេចទ។ ទរមង់េនះរតូវយកេទកន់តុលករេនៃថងសវនករ។
ំ
នករ និងដកី ពកយបណតឹង និងដកី
ENGLISH/KHMER PFA Affidavit
Pa. R.C.P. 1905(d) Rev. 11-08
AOPC Rev. 6-2011
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ំ
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ី
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ំ
Khmer PFA Service Affidavit
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- Sourced from www.pacourts.us (2023-03)
- Page(s): 1
- Fields(s): 23
- Average fields per page: 23
- Reading Level: Grade 10
- LIST Grouping(s):
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n_th_e_cour_f_commo_plea was IN THE COURT OF COMMON PLEAS OF (0.65 conf)fill__1 was fill_2 (0.36 conf)plaintiff was PLAINTIFF (1.00 conf)defendant was DEFENDANT (1.00 conf)fill__2 was fill_4 (0.36 conf)i was I (0.38 conf)fill__3 was fill_7 (0.36 conf)undefined__1 was undefined (0.38 conf)fill__4 was fill_9 (0.36 conf)following_address__1 was at the following address 1 (0.38 conf)following_address__2 was at the following address 2 (0.38 conf)undefined__2 was undefined_2 (0.39 conf)pennsylvania_n was Pennsylvania ON THE (0.40 conf)day was DAY (0.34 conf)of was OF (0.38 conf)unknown was 20 (0.38 conf)fill__5 was fill_15 (0.36 conf)20_2 was 20_2 (0.38 conf)approximately was AT APPROXIMATELY (0.43 conf)fill__6 was fill_19 (0.36 conf)fill__7 was fill_29 (0.36 conf)fill__8 was fill_23 (0.36 conf)text was Text1 (0.35 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
n_th_e_cour_f_commo_pleafill__1fill__2fill__3undefined__1fill__4following_address__1following_address__2undefined__2dayoffill__520_2fill__6fill__7fill__8
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