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
COUNTY OF

NOTICE OF APPEAL
Automated Speed Enforcement
- Active Work Zone

APPELLEE:

NAME and ADDRESS

Mag. Dist. No:

MDJ Name:

Address:

Telephone:

FILING COSTS
POSTAGE

$
$

TOTAL

AMOUNT

DATE PAID

APPELLANT:

NAME and ADDRESS

Docket No:

Case Filed:

TO THE MAGISTERIAL DISTRICT JUDGE:

The above-named Appellant requests that the decision of __________________________________, the PennDOT/
Pennsylvania Turnpike Commission designated hearing officer, be appealed. The penalty owed for the alleged violation is
$_______________.

I verify that the statements herein are true and correct to the best of my knowledge, information and belief. I understand
that false statements herein are made subject to the penalties of Section 4904 of the Crimes Code (18 Pa. C.S. § 4904)
relating to unsworn falsification to authorities.

I certify that this filing complies with the provisions of the Case Records Public Access Policy of the Unified Judicial
System of Pennsylvania that require filing confidential information and documents differently than non-confidential
information or documents.

Date

(Signature of Appellant)

Notice to Appellant

As required by Pa.R.Civ.P.M.D.J. 350(C)(1), a copy of the hearing officer’s decision must be included with this Request for Appeal.

Pursuant to Pa.R.Civ.P.M.D.J. 350(C)(2), you are required to pay all costs for filing and service of the notice of appeal. Should you lack
the financial resources to pay the costs of litigation, you may file a petition to proceed in forma pauperis pursuant to Pa.R.Civ.P.M.D.J.
206(E).

AOPC 9610

FREE INTERPRETER
www.pacourts.us/language-rights

(Untitled)

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): 33
Average fields per page: 33
Reading Level: Grade 9
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.

county was County (0.54 conf)
md_j_name was MDJ Name (0.40 conf)
md_j_phone was MDJ Phone (0.39 conf)
total was Total (0.32 conf)
filing_costs was Filing Costs (0.41 conf)
postage was Postage (0.38 conf)
date_filed was Date Filed (0.44 conf)
filing_costs_date was Filing Costs Date (0.39 conf)
postage_date was Postage Date (0.46 conf)
total_date was Total Date (0.34 conf)
docket was Docket No (0.36 conf)
plaintiff_address__1 was Plaintiff Address 1 (0.48 conf)
defendant was Defendant (1.00 conf)
defendant_address__1 was Defendant Address 1 (0.42 conf)
defendant_address__2 was Defendant Address 2 (0.42 conf)
users1_signature was Signature1 (1.00 conf)
md_j_add__1 was MDJ_Add1 (0.43 conf)
md_j_add__2 was MDJ_Add2 (0.43 conf)
md_j_city was MDJ_City (0.39 conf)
md_j_state was MDJ_State (0.38 conf)
md_j_zip was MDJ_Zip (0.39 conf)
plaintiff_address__2 was Plaintiff Address 2 (0.48 conf)
plaintiff_state was PlaintiffState (0.46 conf)
plaintiff_city was PlaintiffCity (0.48 conf)
def_city was DefCity (0.33 conf)
def_state was DefState (0.39 conf)
plaintiff_zip was PlaintiffZip (0.37 conf)
def_zip was DefZip (0.31 conf)
md_j_number was MDJ Number (0.45 conf)
plaintiff was Plaintiff1 (0.35 conf)
signature_date was Date (1.00 conf)
hearing_officer was hearing officer (0.50 conf)
amount_owed was amount owed (0.39 conf)

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

(Untitled)

About This Form:

Identified Data Fields:

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