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PETITION FOR PROTECTION
FROM ABUSE

NO.

IN THE COURT OF COMMON PLEAS OF
____________________ COUNTY, PENNSYLVANIA

First

Middle

Last

Plaintiff’s DOB

Plaintiff’s Address:
 Plaintiff’s address is confidential or  Plaintiff’s address is: __________________________________________________
__________________________________________________

First

Middle

Last

Suffix

___________________________________________________

CAUTION:

 Weapon Involved
 Weapon Present on the Property
 Weapon Requested Relinquished

DOB
SEX
RACE
HAIR
SSN
DRIVERS
LICENSE #
EXP. DATE

DEFENDANT IDENTIFIERS
HEIGHT
WEIGHT
EYES

STATE

DEMANN POU PWOTEKSYON
KONT MOVE TRETMAN

DEVAN TRIBINAL PREMYE ENSTANS
NAN KONTE ____________________, PENNSILVANI

NIMEWO.

Prenon

Dezyèm prenon

Siyati

Dat Nesans Pleyan an

Adrès Pleyan an:
 Adrès Pleyan an konfidansyèl oswa  Adrès Pleyan an se: ________________________________________________
________________________________________________

1. PLAINTIFF

2. DEFENDANT

Defendant’s Address:

1. PLEYAN

kont

2. AKIZE

Prenon

Dezyèm prenon

Siyati

Adrès Akize a:

IDANTITE AKIZE A

_______________________________________________

PREKOSYON

 Gen Zam nan ensidan an
 Gen Zam sou nan kay la
 Akize a remèt zam yo mande a

DAT NESANS
SÈKS
RAS
CHEVE
NIMEWO SEKIRITE
SOSYAL
# LISANS
CHOFÈ
DAT ESPIRASYON

Sifiks

WOTÈ
PWA
ZYE

ETA

ENGLISH/HATIAN PFA Petition
Pa. R.C. P. 1905(b) Rev. 3-19

Page 1 of 7 / Paj 1 sou 7

AOPC Rev. 4-2019

Defendant’s place of employment is:_______________________
 Check here if you have reason to believe that Defendant is a
licensed firearms dealer, employed by a licensed firearms dealer
or manufacturer; employed as a writer, researcher, or technician
in the firearms or hunting industry, or is required to carry a
firearm as a condition of employment.

Kote Akize a ap travay se:_______________________________
 Tcheke la a si ou gen yon rezon pou kwè Akize a se yon
moun ki gen lisans pou vann zam pou tire; Akize a ap travay pou
yon moun/konpayi ki gen lisans pou vann oswa pou fè zam pou
tire; travay kòm ekriven, chèchè oswa teknisyen nan zam pou tire
oswa nan endistri lachas; oswa travay l ap fè a oblije pote yon
zam pou tire.

3. I am filing this petition on behalf of

 Myself or  Another person

3. Mwen fè demann sa a pou

 mwen oswa  yon lòt moun.

If you checked “myself”, please answer all questions referring to
yourself as “Plaintiff”. If you ONLY checked “another person”,
please answer all questions referring to that person as the
“Plaintiff”, and provide your name and address here, as filer,
unless confidential.

Si w tcheke "mwen", tanpri, reponn tout kesyon anrapò ak
oumenm kòm "Pleyan". Si ou tcheke SÈLMAN "yon lòt moun",
tanpri, reponn tout kesyon anrapò ak moun sa a kòm "Pleyan",
epi bay non w ak adrès ou la a, kòm moun ki depoze demann lan,
sòf si li konfidansyèl.

Filer’s Name / Non moun ki depoze demann lan

First / Prenon

Middle / Dezyèm prenon

Last / Siyati

Suffix / Sifiks

 Filer’s address is confidential or
 Filer’s address is:
____________________________________________________

 Adrès moun ki depoze demann lan konfidansyèl oswa
 Adrès moun ki depoze demann lan se:
____________________________________________________

If you checked “Another Person”, indicate your relationship with
Plaintiff:

Si w tcheke "yon lòt moun", di kisa ou ye pou Pleyan an:

 parent of minor Plaintiff(s)
 applicant for appointment as guardian ad litem of minor

 paran Pleyan minè
 aplikan pou yo nonmen kòm gadyen legal ad litem (pou dosye

Plaintiff(s)

sa) Pleyan minè a(yo)

 adult household member with minor Plaintiff(s)
 court appointed guardian of incompetent Plaintiff(s)

 adilt ki nan kay avèk Pleyan minè
 gadyen legal tribinal nonmen pou Pleyan ki pa ka defann tèt li

4. Name(s) of all persons, including minor child/ren, who seek
protection from abuse:_________________________________

4. Non tout moun, san bliye timoun minè k ap chèche pwoteksyon
kont move tretman: ___________________________________

___________________________________________________

_____________________________________________________

___________________________________________________

_____________________________________________________

___________________________________________________

_____________________________________________________

5. Indicate the relationship between Plaintiff and Defendant:
CHECK ALL THAT APPLY:
 spouse or former spouse of Defendant
 parent of a child with Defendant
 current or former sexual or intimate partner with Defendant
 child of Plaintiff
 child of Defendant
 family member related by blood (consanguinity) to

Defendant

 family member related by marriage or affinity to Defendant
 sibling (person who shares parenthood) of Defendant

5. Di kisa Pleyan an ak Akize a ye youn pou lòt:
TCHEKE TOUT SA KI APLIKE:
 mari/madanm oswa ansyen mari/madanm Akize a
 paran yon timoun li gen ak Akize a
 patnè seksyèl oswa entim akize genyen kounye a oswa te

genyen anvan
 pitit Pleyan an
 pitit Akize a
 manm fanmi nan san (konsangen) ak Akize a
 fanmi akize a swa pa maryaj oswa pa alyans
 frè ak sè (moun ki gen menm papa/maman) ak Akize a

 Check here if Defendant is 17 years old or younger.

 Tcheke la a si Akize a gen 17 an oswa mwens.

ENGLISH/HAITIAN PFA Petition
Pa. P.C. P. 1905(b) Rev. 3-19

Page 2 of 7 / Paj 2 sou 7

AOPC Rev. 4-2019

6. Have Plaintiff and Defendant been involved in any of the
following court actions?

6. Èske Pleyan ak Akize a te enplike nan nenpòt nan pwosè sa yo?

 Divorce
 Custody
 Support
 Protection from Abuse

 Divòs
 Lagad timoun
 Sipò
 Pwoteksyon kont Abi

If you checked any of the above, briefly indicate when and where
the case was filed and the court number, if known:
_____________________________________________________

Si w tcheke nenpòt nan sa ki anwo a, di tou kout ki lè epi ki kote yo
te depoze dosye a ansanm ak nimewo tribunal la, si w konnen:

__________________________________________________

_____________________________________________________

__________________________________________________

7. Has Defendant been involved in any criminal court action?
_____________________________________________________

7. Èske Akize a te enplike nan nenpòt pwosè kriminèl?
______________________________________________________

If you answered Yes, is Defendant currently on probation?
___________________________________________________

Si w reponn Wi, èske Akize a aktyèlman nan libète siveye?
____________________________________________________

Has Defendant been determined to be a perpetrator in a
founded or indicated report under the Child Protective Services
Law, 23 Pa.C.S. §§ 6301 – 6386? _______________________

Èske yo te detèmine Akize a te yon moun ki komèt yon zak dapre
yon rapò ki fonde oswa ki endike dapre Lwa sou Sèvis
Pwoteksyon Timoun , 23 Pa.C.S. §§ 6301 – 6386? ___________

If you answered Yes, what county’s court or child protective
services agency issued the founded or indicated report?
___________________________________________________

Si w reponn Wi, tribinal ki konte oswa ki ajans sèvis pwoteksyon
ki te bay rapò ki fonde oswa ki endike a?
____________________________________________________

8. Plaintiff and Defendant are the parents of the following minor
child/ren:

8. Pleyan an ak Akize a se paran timoun sa yo ki minè:

Name(s) / Non yo

Age(s) / Laj yo

Who reside at (list address unless confidential) /
Ki abite nan (bay adrès la sòf si li konfidansyèl)

9. If Plaintiff and Defendant are parents of any minor child/ren
together, is there an existing court order regarding their custody?

9. Si Pleyan an ak Akize a se paran nenpòt timoun minè(yo), èske
gen yon lòd tribinal ki egziste konsènan sipèvizyon timoun yo?

 YES  NO

 WI  NON

If you answered “Yes,” describe the terms of the order (e.g.,
primary, shared, legal or physical custody):
_________________________________________________
_________________________________________________

Si w reponn "Wi," dekri kondisyon ki nan lòd la (pa egzanp,
prensipal, pataje, legal oswa gad legal fizik):
__________________________________________________
__________________________________________________

If you answered “yes”, in what county and state was the
order issued?
_________________________________________________

If you are now seeking an order of child custody as part of
this petition, list the following information:

Si w reponn "wi", nan ki konte ak eta yo te bay lòd la?

_________________________________________________
Si w ap chèche kounye a yon lòd pou sipèvizyon timoun kòm
yon pati nan petisyon sa a, mete enfòmasyon sa yo:

(a) Where has each child resided during the past five years?

(a) Ki kote chak timoun te abite pandan senk ane ki sot pase yo?

Child’s Name /
Non timoun nan

Person(s) child lived with /
Moun timoun nan te abite ak li

Address, unless confidential /
Adrès, sòf si li konfidansyèl

When? / Kilè?

ENGLISH/HAITIAN PFA Petition
Pa. P.C. P. 1905(b) Rev. 3-19

Page 3 of 7 / Paj 3 sou 7

AOPC Rev. 4-2019

(b) List any other persons who are known to have or claim a
right to custody of each child listed above.

(b) Bay tout lòt moun ou konnen ki gen yon dwa oswa ki ka fè
konnen li gen yon dwa pou sipèvizyon chak timoun ki site anwo
a.

Name / Non

Address / Adrès

Basis of claim / Rezon pou demann lan

10. The following other minor child/ren presently live with
Plaintiff:

10. Lòt timoun minè sa yo ap viv kounye a avèk Pleyan an:

Name(s) / Non yo

Age(s) / Laj yo

Plaintiff’s Relationship to Child/ren /
Kisa Pleyan an ye pou timoun nan/yo

11. The facts of the most recent incident of abuse are as follows:

11. Men detay sou dènye ensidan ki gen pou wè ak move tretman an:

Approximate date: ___________________________
Approximate time: ___________________________
Place: ___________________________________________
Describe in detail what happened, including any physical or
sexual abuse, threats, injury, incidents of stalking, medical
treatment sought, or calls to law enforcement (attach
additional sheets of paper if necessary):
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________

Dat apeprè: ________________________________
Lè apeprè: _________________________________
Kikote: _________________________________________
Dekri andetay sa ki te pase a, mete ladan nenpòt move tretman
fizik oubyen seksyèl, menas, blesi, ensidan kote akize a t ap
suiv ou,, tretman medikal ou t al pran, oswa si w te rele lapolis
(tache lòt fèy papye si nesesè):
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________

12. If Defendant has committed prior acts of abuse against
Plaintiff or the minor child/ren, describe these prior
incidents, including any threats, injuries, or incidents of
stalking, and indicate approximately when such acts of abuse
occurred (attach additional sheets of paper if necessary):

12. Si Akize a te komèt zak move tretman kont Pleyan an oswa

kont timoun minè yo anvansa, dekri ensidan ki te fèt anvan yo,
mete ladan nenpòt menas, blesi, oswa ensidan kote akize a t ap
suiv ou, epi di apeprè kilè zak move tretman sa yo te fèt(tache
lòt fèy papye si nesesè)

________________________________________________

13. (a) Has Defendant used or threatened to use any firearms or

other weapons against Plaintiff or the minor child/ren? If
so, please describe the use or threatened use below and
list on Attachment A to Petition, which is incorporated
by reference into this petition, any firearms, other
weapons, or ammunition Defendant used or threatened
to use against Plaintiff or the minor child/ren:

13. (a) Èske Akize a te itilize oswa te menase pou sèvi ak nenpòt
zam pou tire oubyen lòt zam sou Pleyan an oswa timoun
minè yo? Si li te fè l, tanpri dekri itilizasyon oswa menas
itilizasyon an anba a epi bay nan Dokiman Siplemantè A,
ki nan demann sa a pou referans, nenpòt zam pou tire, lòt
zam oswa minisyon Akize a te itilize oswa te menase
itilize sou Pleyan an oswa sou timoun minè yo:

_____________________________________________

Page 4 of 7 / Paj 4 sou 7

_____________________________________________
AOPC Rev. 4-2019

ENGLISH/HAITIAN PFA Petition
Pa. P.C. P. 1905(b) Rev. 3-19

_____________________________________________

(b) Other than the firearms, other weapons, or ammunition
Defendant used or threatened to use against Plaintiff or
the minor child/ren, does Defendant, to the best of your
knowledge or belief, own or possess any additional
firearm, other weapon, ammunition, or any firearm
license?
□ Yes □ No

(b) Apa zam pou tire, lòt zam, oswa minisyon Akize a te
itilize oswa te menase itilize kont Pleyan an oswa
timoun minè yo, dapre sa ou konnen oswa ak tout
konvisyon w, èske Akize a posede oswa gen nan men l
nenpòt lòt zam pou tire, lòt zam, minisyon, oswa nenpòt
lisans pou zam pou tire?
□ Wi □ Non

(c)

If the answer to (b) above is “yes,” list any additional
firearm, other weapon, or ammunition owned by or in
the possession of Defendant on Attachment A to
Petition, which is incorporated by reference into this
petition.

(d) Plaintiff (Check one)  DOES /  DOES NOT
request that the court order Defendant to relinquish
firearms, other weapons, or ammunition listed on
Attachment A to Petition. If Plaintiff does seek
relinquishment, identify on Attachment A to Petition the
firearms, other weapons, or ammunition Plaintiff
requests the court to order Defendant to relinquish.

(c) Si repons pou kesyon (b) anwo a se "wi", bay sou
Dokiman Siplemantè A, ki nan demann sa a pou
referans, tout lòt zam pou tire, lòt zam, oswa minisyon
Akize a posede oswa li gen nan men li.

(d) Pleyan an (Tcheke youn ladan yo)  MANDE / PA
MANDE pou tribinal la òdone Akize a remèt zam pou
tire, lòt zam, oswa minisyon ki site nan Dokiman
siplemantè A ki fè pati Demann lan. Si Pleyan an ap
mande pou akize a remèt zam yo, nan Dokiman
Siplemantè A, ki fè pati Demann lan, idantifye zam pou
tire, lòt kalite zam, oswa minisyon ke Pleyan an mande
tribinal la bay Akize a lòd pou li remèt.

14. Identify the sheriff, police department, or law enforcement
agency in the area in which Plaintiff lives that should be provided
with a copy of the protection order:
__________________________________________________

14. Idantifye cherif, depatman lapolis la, oswa ajans legal la nan
zòn kote Pleyan an ap viv la, ki ta dwe resevwa yon kopi lòd
pwoteksyon an:
__________________________________________________

15. There is an immediate and present danger of further abuse
from Defendant.

15. Gen yon danje tousuit oswa danje egziste pou Akize a fè plis
move tretman.

CHECK THE FOLLOWING BOXES ONLY IF THEY APPLY
TO YOUR CASE AND PROVIDE THE REQUESTED
INFORMATION:

TCHEKE TI KARE ANNAPRE YO SÈLMAN SI YO APLIKE
POU DOSYE OU LAN EPI BAY ENFÒMASYON YO
MANDE A:

 Plaintiff is asking the court to evict and exclude Defendant
from the following residence:
 owned by (list owners, if known): ______________________
 rented by (list all names, if known): ____________________
 Defendant owes a duty of support to Plaintiff or the minor
child/ren.
 Plaintiff has suffered out-of-pocket financial losses as a result
of the abuse described above.

 Pleyan an ap mande Tribinal la pou mete deyò epi eskli Akize
a soti nan rezidans sa a:
 mèt kay la (liste pwopriyetè yo, si yo konnen yo): __________
 lokatè (liste tout non yo, si yo konnen yo):________________
Akize a blije sipòte Pleyan oswa timoun minè a/yo.

 Pleyan an te soufri pèt lajan ki soti nan pòch li difèt move
tretman ki dekri anwo a.

Those losses are:_______________________________________
_________________________________________________

Men pèt yo: __________________________________________
____________________________________________________

FOR THE REASONS SET FORTH ABOVE, I REQUEST

THAT THE COURT ENTER A TEMPORARY ORDER,
AND AFTER A HEARING, A FINAL ORDER THAT
WOULD DO THE FOLLOWING (CHECK ALL FORMS
OF RELIEF REQUESTED):

POU REZON KI TABLI ANWO A, MWEN MANDE POU
TRIBINAL LA BAY YON LÒD TANPORÈ, EPI APRE YON
ODYANS, BAY YON LÒD FINAL KI TA FÈ BAGAY SA YO
(TCHEKE TOUT KALITE REPARASYON OU MANDE YO):

ENGLISH/HAITIAN PFA Petition
Pa. P.C. P. 1905(b) Rev. 3-19

Page 5 of 7 / Paj 5 sou 7

AOPC Rev. 4-2019

 A. Restrain the Defendant from abusing, harassing, stalking,
threatening, or attempting or threatening to use physical force
against Plaintiff or the minor child/ren in any place where
Plaintiff or the child/ren may be found.

 A. Anpeche Akize a maltrete, asele, swiv toupatou, oswa
eseye oswa menase pou itilize fòs fizik kont Pleyan an ak/oswa
timoun minè yo kèlkanswa kote Pleyan an ak/oswa timoun yo ta
ye.

 B. Evict/exclude the Defendant from Plaintiff’s residence and
prohibit Defendant from attempting to enter any temporary or
permanent residence of Plaintiff.

 B. Degèpi/ pa pèmèt Akize a rete nan kay Pleyan an epi
entèdi Akize a eseye antre nan nenpòt kay tanporè oswa pèmanan
Pleyan an.

 C. Require Defendant to provide Plaintiff or the minor
child/ren with other suitable housing.

 C. Mande pou Akize a bay Pleyan an oswa timoun minè yo
lòt lojman ki apwopriye.

 D. Award Plaintiff temporary custody of the minor child/ren
and place the following restrictions on contact between Defendant
and the child/ren:

 D. Akòde Pleyan an sipèvizyon fizik e legal tanporè timoun
minè yo epi mete restriksyon kontak sa yo ant Akize a ak timoun
nan/yo:

____________________________________________________

_____________________________________________________

____________________________________________________
____________________________________________________
____________________________________________________

_____________________________________________________
_____________________________________________________
_____________________________________________________

 E. Prohibit Defendant from having any contact with Plaintiff
or the minor child/ren, in person, by telephone, or in writing,
personally or through third persons, including but not limited to
any contact at Plaintiff’s school, business or place of
employment, except as the court may find necessary with respect
to partial custody with the minor child/ren.

 E. Entèdi Akize a gen kèlkanswa kontak avèk Pleyan an
oswa timoun minè yo, keseswa anpèsòn, pa telefòn, oubyen
alekri, pèsonèlman oswa pa lentèmedyè lòt moun. Epitou, tribinal
la entèdi Akize a gen kontak nan lekòl, nan biznis oswa nan
travay Pleyan an, eksepte si tribinal la kwè kontak la nesesè pou
sipèvizyon an pati ak/oswa pou vizit ak timoun ki minè yo.

 F. Prohibit Defendant from having any contact with
Plaintiff’s relatives and Plaintiff’s child/ren listed in this Petition,
except as the court may find necessary with respect to partial
custody with minor child/ren. The following persons are
Plaintiff’s relatives or family and household members that
Plaintiff believes require protection from stalking and harassment
by Defendant.

 F. Entèdi Akize a gen kèlkanswa kontak avèk fanmi Pleyan
an e pitit Pleyan an ki site nan Demann sa a, eksepte si tribinal la
kwè kontak la nesesè pou sipèvizyon an pati ak/oswa pou vizit ak
timoun ki minè yo. Moun sa yo se fanmi Pleyan an oswa manm
fanmi ak moun nan kay li Pleyan an kwè ki merite pwoteksyon
pou Akize a pa anbete yo nan asèlman ak suiv toupatou.

Name / Non

Address / Adrès

Relationship to Plaintiff /
Kisa yo ye pou Pleyan an

 G. Order Defendant to temporarily relinquish the firearms,
other weapons, or ammunition listed on Attachment A to Petition
under Defendant’s control, or in Defendant’s possession, or any
firearm license to the sheriff or the appropriate law enforcement
agency.

 G. Bay Akize a lòd pou li remèt tanporèman zam pou tire, lòt
zam, oswa minisyon ki endike nan Atachman A Petisyon an, anba
kontwòl Akize a, oswa nan posesyon Akize a, oswa nenpòt lisans
zam pou tire li bay cherif la oswa ajans legal apwopriye.

 H. Prohibit Defendant from acquiring or possessing firearms
for the duration of the order.

 H. Entèdi Akize a pou trape oswa posede zam pou tire pandan
tout tan lòd la dire

 I. Order Defendant to pay temporary support for Plaintiff or
the minor child/ren, including medical support and payment of
the rent or mortgage on the residence.

 I. Bay lòd pou peye sipò tanporè pou Pleyan oswa
timoun minè a/yo, tankou sipò medikal ak peman lwaye
oswa prè ipotekè ki sou rezidans lan.

 J. Direct Defendant to pay Plaintiff for the reasonable
financial losses suffered as the result of the abuse, to be
determined at the hearing.

 J. Bay Akize a lòd pou peye Pleyan an pou pèt finansye
rezonab li sibi akòz move tretman an, yon montan tribinal la ap
detèmine pandan odyans lan.

ENGLISH/HAITIAN PFA Petition
Pa. P.C. P. 1905(b) Rev. 3-19

Page 6 of 7 / Paj 6 sou 7

AOPC Rev. 4-2019

 K. Order Defendant to pay the costs of this action, including
filing and service fees.

 L. Order Defendant to pay Plaintiff’s reasonable attorney’s
fees.

 K. Bay Akize a lòd pou peye frè pwosedi nan tribinal la koute
a, ansanm ak frè pou depoze dokiman yo nan tribinal la ak frè
pou pote papye yo bay akize a.

 L. Bay Akize a lòd pou peye frè nòmal avoka Pleyan an.

 M. Order the following additional relief, not listed above:

 M. Bay lòd pou reparasyon anplis, ki pa nan lis anwo a:

___________________________________________________

 N. Grant such other relief as Plaintiff requests or the court
deems appropriate.

 N. Akòde lòt reparasyon, jan Pleyan an mande ak/oswa lòt
reparasyon tribinal la deside ki apwopriye.

 O. Order the police, sheriff, or other law enforcement agency
to serve Defendant with a copy of this petition, any order issued,
and the order for hearing. Plaintiff will inform the designated
authority of any addresses, other than Defendant’s residence,
where Defendant can be served.

 O. Bay lapolis, cherif la, oswa lòt biwo lalwa lòd pou remèt
Akize a yon kopi demann sa a, nenpòt lòd tribinal la bay epi
papye Desizyon ki pran nan Odyans lan. Pleyan an ap bay otorite
ki la pou sa nenpòt adrès, ki pa menm ak rezidans Akize a, kote
yo kapab remèt yo ba Akize a.

 P. Direct the Pennsylvania State Police, the municipal police,
or the sheriff to accompany Plaintiff to his or her residence to
retrieve personal belongings or accompany Plaintiff while the
petition or order is served on Defendant, if Plaintiff has reason to
believe his or her safety is at risk.

 P. Dirije Lapolis Eta Pennsylvania, polis minisipal la, oswa
cherif la pou akonpanye Pleyan an nan rezidans li pou pran zafè
pèsonèl li yo oswa pou akonpaye Pleyan an pandan y ap remèt
Akize a demann oswa lòd la, si Pleyan an gen rezon pou kwè ke li
andanje.

VERIFICATION

KONFIMASYON

I verify that I am the petitioner as designated in the

present action and that the facts and statements contained in
the above Petition are true and correct to the best of my
knowledge.

Mwen konfime se mwenmenm ki Demandè a nan aksyon sa
a epi detay ak deklarasyon ki nan demann ki piwo a se
laverite e yo korèk selon sa mwen konnen byen.

I understand that any false statements are made subject to
to unsworn

the penalties of 18 Pa.C.S. §4904, relating
falsification to authorities.

Mwen konnen si mwen fè nenpòt fo deklarasyon, yo
kapab pran sanksyon kont mwen dapre 18 Pa.C.S. §4904, yon
lalwa ki gen rapò ak bay leta enfòmasyon ki fo san fè sèman.

______________________________________

__________________________________________

Date /Dat

Signature / Siyati

ENGLISH/HAITIAN PFA Petition
Pa. P.C. P. 1905(b) Rev. 3-19

Page 7 of 7 / Paj 7 sou 7

AOPC Rev. 4-2019

Haitian Creole Peition for Protection from Abuse

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): 7
Fields(s): 313
Average fields per page: 44
Reading Level: Grade 10
LIST Grouping(s): GO-00-00-00-00.

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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.

n_th_e_cour_f_commo_plea was IN THE COURT OF COMMON PLEAS OF (0.65 conf)
address_confidential was Plaintiffs address is confidential (0.44 conf)
plaintiffs_address was Plaintiffs address is (0.42 conf)
last__1 was Last 1 (0.34 conf)
last__2 was Last 2 (0.34 conf)
defendants_address was Defendants Address (0.32 conf)
users1_birthdate was DOB (1.00 conf)
height was HEIGHT (0.36 conf)
sex was SEX (0.38 conf)
weight was WEIGHT (0.36 conf)
race was RACE (0.41 conf)
eyes was EYES (0.34 conf)
weapon_involved was Weapon Involved (0.37 conf)
weapon_present_property was Weapon Present on the Property (0.35 conf)
weapon_requested_relinquished was Weapon Requested Relinquished (0.34 conf)
hair was HAIR (0.34 conf)
ssn was SSN (0.34 conf)
driver_license was DRIVERS LICENSE (0.46 conf)
ex_p_date was EXP DATE (0.32 conf)
users1_address_state was STATE (1.00 conf)
deva_n_tribina_l_premy_e_enstans was DEVAN TRIBINAL PREMYE ENSTANS (0.54 conf)
adr_pleyan_konfidansy_l was Adrès Pleyan an konfidansyèl (0.32 conf)
adr_pleyan_se was Adrès Pleyan an se (0.47 conf)
siyati__1 was Siyati 1 (0.38 conf)
siyati__2 was Siyati 2 (0.38 conf)
adr_akize was Adrès Akize a (0.32 conf)
da_nesans was DAT NESANS (0.34 conf)
wo was WOTÈ (0.40 conf)
ks was SÈKS (0.48 conf)
pwa was PWA (0.43 conf)
ras was RAS (0.47 conf)
zye was ZYE (0.35 conf)
gen_zam_nan_ensidan was Gen Zam nan ensidan an (0.50 conf)
gen_zam_sou_nan_kay_la was Gen Zam sou nan kay la (0.49 conf)
akize_rem_zam_yo_mande was Akize a remèt zam yo mande a (0.37 conf)
cheve was CHEVE (0.35 conf)
nimew_sekirit_e_sosyal was NIMEWO SEKIRITE SOSYAL (0.38 conf)
lisan_cho_f was LISANS CHOFÈ (0.46 conf)
da_espirasyon was DAT ESPIRASYON (0.34 conf)
eta was ETA (0.53 conf)
text__1 was Text1 (0.35 conf)
text__2 was Text2 (0.35 conf)
text__3 was Text3 (0.35 conf)
text__4 was Text4 (0.35 conf)
text__5 was Text5 (0.35 conf)
text__6 was Text7 (0.35 conf)
defendants_place_employment was Defendants place of employment is (0.34 conf)
kote_akize_ap_travay_se was Kote Akize a ap travay se (0.49 conf)
check_reason_believe was Check here if you have reason to believe that Defendant is a (0.45 conf)
la_si_ou_yon_pou_se was Tcheke la a si ou gen yon rezon pou kwè Akize a se yon (0.49 conf)
myself was Myself (0.36 conf)
another_person was Another person (0.50 conf)
mwen was mwen (0.35 conf)
yon_l_moun was yon lòt moun (0.46 conf)
filers_address_confidential was Filers address is confidential (0.42 conf)
filers_address was Filers address is (0.45 conf)
adr_moun_ki_depoze_demann_lan_konfidansy_l was Adrès moun ki depoze demann lan konfidansyèl (0.43 conf)
adr_moun_ki_depoze_demann_lan_se was Adrès moun ki depoze demann lan se (0.46 conf)
undefined__1 was undefined (0.38 conf)
undefined__2 was undefined_2 (0.39 conf)
parent_minor_plaintiffs was parent of minor Plaintiffs (0.52 conf)
appointment_ad_minor was applicant for appointment as guardian ad litem of minor (0.39 conf)
household_member_minor was adult household member with minor Plaintiffs (0.51 conf)
court_incompetent_plaintiffs was court appointed guardian of incompetent Plaintiffs (0.46 conf)
paran_pleyan_min was paran Pleyan minè (0.35 conf)
pou_yo_k_legal_ad was aplikan pou yo nonmen kòm gadyen legal ad litem pou dosye (0.53 conf)
adilt_ki_nan_kay_av_k_pleyan_min was adilt ki nan kay avèk Pleyan minè (0.45 conf)
pou_ki_pa_ka_li was gadyen legal tribinal nonmen pou Pleyan ki pa ka defann tèt li (0.53 conf)
persons_minor_children was 4 Names of all persons including minor children who seek (0.39 conf)
non_tout_moun_k_ap_che was 4 Non tout moun san bliye timoun minè k ap chèche pwoteksyon (0.53 conf)
protection_abuse__1 was protection from abuse 1 (0.30 conf)
protection_abuse__2 was protection from abuse 2 (0.30 conf)
protection_abuse__3 was protection from abuse 3 (0.30 conf)
kont_move_tretman__1 was kont move tretman 1 (0.51 conf)
kont_move_tretman__2 was kont move tretman 2 (0.51 conf)
kont_move_tretman__3 was kont move tretman 3 (0.51 conf)
spouse_former_defendant was spouse or former spouse of Defendant (0.47 conf)
parent_child_defendant was parent of a child with Defendant (0.38 conf)
current_sexual_partner was current or former sexual or intimate partner with Defendant (0.53 conf)
child_plaintiff was child of Plaintiff (0.46 conf)
child_defendant was child of Defendant (0.50 conf)
family_related_blood was family member related by blood consanguinity to (0.28 conf)
member_related_defendant was family member related by marriage or affinity to Defendant (0.45 conf)
sibling_person_defendant was sibling person who shares parenthood of Defendant (0.38 conf)
check_years_old_younger was Check here if Defendant is 17 years old or younger (0.37 conf)
marimadanm_oswa_ansyen_akize was marimadanm oswa ansyen marimadanm Akize a (0.32 conf)
paran_yon_timoun_li_gen_ak_akize was paran yon timoun li gen ak Akize a (0.47 conf)
patn_seksy_l_oswa_entim_akize_genyen_kounye_te was patnè seksyèl oswa entim akize genyen kounye a oswa te (0.49 conf)
pitit_pleyan was pitit Pleyan an (0.32 conf)
pitit_akize was pitit Akize a (0.32 conf)
manm_fanmi_nan_san_konsangen_ak_akize was manm fanmi nan san konsangen ak Akize a (0.43 conf)
fanmi_akize_swa_pa_maryaj_oswa_alyans was fanmi akize a swa pa maryaj oswa pa alyans (0.41 conf)
fr_ak_moun_ki_gen_menm_papamaman_akize was frè ak sè moun ki gen menm papamaman ak Akize a (0.46 conf)
tcheke_la_si_akize_gen_oswa_mwens was Tcheke la a si Akize a gen 17 an oswa mwens (0.40 conf)
text__7 was Text6 (0.35 conf)
divorce was Divorce (0.41 conf)
custody was Custody (0.47 conf)
support was Support (0.43 conf)
protection_abuse__4 was Protection from Abuse (0.29 conf)
div was Divòs (0.35 conf)
lagad_timoun was Lagad timoun (0.35 conf)
sip was Sipò (0.35 conf)
pwoteksyon_kont_abi was Pwoteksyon kont Abi (0.51 conf)
case_filed_court_number_known__1 was the case was filed and the court number if known 1 (0.39 conf)
case_filed_court_number_known__2 was the case was filed and the court number if known 2 (0.39 conf)
te_depoze_dosye_ansanm_ak_nimewo_tribunal_la_si_w_konnen__1 was te depoze dosye a ansanm ak nimewo tribunal la si w konnen 1 (0.50 conf)
te_depoze_dosye_ansanm_ak_nimewo_tribunal_la_si_w_konnen__2 was te depoze dosye a ansanm ak nimewo tribunal la si w konnen 2 (0.50 conf)
defendant_criminal_court was 7 Has Defendant been involved in any criminal court action (0.42 conf)
ske_akize_te_enplike_nan_nenp_pwos_krimin_l was 7 Èske Akize a te enplike nan nenpòt pwosè kriminèl (0.45 conf)
yes_defendant_probation was If you answered Yes is Defendant currently on probation (0.43 conf)
si_wi_ske_nan_lib_te was Si w reponn Wi èske Akize a aktyèlman nan libète siveye (0.47 conf)
report_child_services was founded or indicated report under the Child Protective Services (0.32 conf)
yon_ki_fonde_lwa_sou_vis was yon rapò ki fonde oswa ki endike dapre Lwa sou Sèvis (0.52 conf)
services_agency_report was services agency issued the founded or indicated report (0.36 conf)
ki_te_bay_rap_fonde_oswa_endike was ki te bay rapò ki fonde oswa ki endike a (0.48 conf)
names_non_yo_row__1 was Names Non yoRow1 (0.48 conf)
ages_laj_yo_row__1 was Ages Laj yoRow1 (0.39 conf)
unless_ki_nan_la_l__1 was Who reside at list address unless confidential Ki abite nan bay adrès la sòf si li konfidansyèlRow1 (0.46 conf)
names_non_yo_row__2 was Names Non yoRow2 (0.48 conf)
ages_laj_yo_row__2 was Ages Laj yoRow2 (0.39 conf)
unless_ki_nan_la_l__2 was Who reside at list address unless confidential Ki abite nan bay adrès la sòf si li konfidansyèlRow2 (0.46 conf)
names_non_yo_row__3 was Names Non yoRow3 (0.48 conf)
ages_laj_yo_row__3 was Ages Laj yoRow3 (0.39 conf)
unless_ki_nan_la_l__3 was Who reside at list address unless confidential Ki abite nan bay adrès la sòf si li konfidansyèlRow3 (0.46 conf)
names_non_yo_row__4 was Names Non yoRow4 (0.48 conf)
ages_laj_yo_row__4 was Ages Laj yoRow4 (0.39 conf)
unless_ki_nan_la_l__4 was Who reside at list address unless confidential Ki abite nan bay adrès la sòf si li konfidansyèlRow4 (0.46 conf)
names_non_yo_row__5 was Names Non yoRow5 (0.48 conf)
ages_laj_yo_row__5 was Ages Laj yoRow5 (0.39 conf)
unless_ki_nan_la_l__5 was Who reside at list address unless confidential Ki abite nan bay adrès la sòf si li konfidansyèlRow5 (0.46 conf)
yes__1 was YES (0.45 conf)
no__1 was NO (0.45 conf)
wi__1 was WI (0.39 conf)
non__1 was NON (0.48 conf)
primary_shared_legal__1 was primary shared legal or physical custody 1 (0.49 conf)
primary_shared_legal__2 was primary shared legal or physical custody 2 (0.49 conf)
prensipal_pataje_legal_oswa_gad_fizik__1 was prensipal pataje legal oswa gad legal fizik 1 (0.41 conf)
prensipal_pataje_legal_oswa_gad_fizik__2 was prensipal pataje legal oswa gad legal fizik 2 (0.41 conf)
order_issued was order issued (0.41 conf)
wi_nan_ki_ak_bay_l_la was Si w reponn wi nan ki konte ak eta yo te bay lòd la (0.52 conf)
childs_name_non_timoun_nan_row__1 was Childs Name Non timoun nanRow1 (0.45 conf)
child_lived_moun_nan_ak_li__1 was Persons child lived with Moun timoun nan te abite ak liRow1 (0.56 conf)
address_unless_confidential_l_row__1 was Address unless confidential Adrès sòf si li konfidansyèlRow1 (0.36 conf)
kil_row__1 was When KilèRow1 (0.45 conf)
childs_name_non_timoun_nan_row__2 was Childs Name Non timoun nanRow2 (0.45 conf)
child_lived_moun_nan_ak_li__2 was Persons child lived with Moun timoun nan te abite ak liRow2 (0.56 conf)
address_unless_confidential_l_row__2 was Address unless confidential Adrès sòf si li konfidansyèlRow2 (0.36 conf)
kil_row__2 was When KilèRow2 (0.45 conf)
childs_name_non_timoun_nan_row__3 was Childs Name Non timoun nanRow3 (0.45 conf)
child_lived_moun_nan_ak_li__3 was Persons child lived with Moun timoun nan te abite ak liRow3 (0.56 conf)
address_unless_confidential_l_row__3 was Address unless confidential Adrès sòf si li konfidansyèlRow3 (0.36 conf)
kil_row__3 was When KilèRow3 (0.45 conf)
childs_name_non_timoun_nan_row__4 was Childs Name Non timoun nanRow4 (0.45 conf)
child_lived_moun_nan_ak_li__4 was Persons child lived with Moun timoun nan te abite ak liRow4 (0.56 conf)
address_unless_confidential_l_row__4 was Address unless confidential Adrès sòf si li konfidansyèlRow4 (0.36 conf)
kil_row__4 was When KilèRow4 (0.45 conf)
name_non_row__1 was Name NonRow1 (0.46 conf)
address_adr_row__1 was Address AdrèsRow1 (0.36 conf)
basis_claim_rezon_demann_lan_row__1 was Basis of claim Rezon pou demann lanRow1 (0.39 conf)
name_non_row__2 was Name NonRow2 (0.46 conf)
address_adr_row__2 was Address AdrèsRow2 (0.36 conf)
basis_claim_rezon_demann_lan_row__2 was Basis of claim Rezon pou demann lanRow2 (0.39 conf)
name_non_row__3 was Name NonRow3 (0.46 conf)
address_adr_row__3 was Address AdrèsRow3 (0.36 conf)
basis_claim_rezon_demann_lan_row__3 was Basis of claim Rezon pou demann lanRow3 (0.39 conf)
name_non_row__4 was Name NonRow4 (0.46 conf)
address_adr_row__4 was Address AdrèsRow4 (0.36 conf)
basis_claim_rezon_demann_lan_row__4 was Basis of claim Rezon pou demann lanRow4 (0.39 conf)
names_non_yo_row__6 was Names Non yoRow1_2 (0.39 conf)
ages_laj_yo_row__6 was Ages Laj yoRow1_2 (0.34 conf)
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__1 was Plaintiffs Relationship to Children Kisa Pleyan an ye pou timoun nanyoRow1 (0.48 conf)
names_non_yo_row__7 was Names Non yoRow2_2 (0.39 conf)
ages_laj_yo_row__7 was Ages Laj yoRow2_2 (0.34 conf)
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__2 was Plaintiffs Relationship to Children Kisa Pleyan an ye pou timoun nanyoRow2 (0.48 conf)
names_non_yo_row__8 was Names Non yoRow3_2 (0.39 conf)
ages_laj_yo_row__8 was Ages Laj yoRow3_2 (0.34 conf)
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__3 was Plaintiffs Relationship to Children Kisa Pleyan an ye pou timoun nanyoRow3 (0.48 conf)
names_non_yo_row__9 was Names Non yoRow4_2 (0.39 conf)
ages_laj_yo_row__9 was Ages Laj yoRow4_2 (0.34 conf)
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__4 was Plaintiffs Relationship to Children Kisa Pleyan an ye pou timoun nanyoRow4 (0.48 conf)
facts_recent_incident_follows__1 was 11 The facts of the most recent incident of abuse are as follows 1 (0.40 conf)
facts_recent_incident_follows__2 was 11 The facts of the most recent incident of abuse are as follows 2 (0.40 conf)
sou_nye_ki_gen_pou_ak was 11 Men detay sou dènye ensidan ki gen pou wè ak move tretman an (0.46 conf)
dat_apepr was Dat apeprè (0.31 conf)
approximate_time was Approximate time (0.34 conf)
l_apepr was Lè apeprè (0.35 conf)
additional_sheets_paper__1 was additional sheets of paper if necessary 1 (0.37 conf)
additional_sheets_paper__2 was additional sheets of paper if necessary 2 (0.37 conf)
additional_sheets_paper__3 was additional sheets of paper if necessary 3 (0.37 conf)
additional_sheets_paper__4 was additional sheets of paper if necessary 4 (0.37 conf)
additional_sheets_paper__5 was additional sheets of paper if necessary 5 (0.37 conf)
additional_sheets_paper__6 was additional sheets of paper if necessary 6 (0.37 conf)
additional_sheets_paper__7 was additional sheets of paper if necessary 7 (0.37 conf)
additional_sheets_paper__8 was additional sheets of paper if necessary 8 (0.37 conf)
additional_sheets_paper__9 was additional sheets of paper if necessary 9 (0.37 conf)
tache_l_f_papye_si_neses__1 was tache lòt fèy papye si nesesè 1 (0.49 conf)
tache_l_f_papye_si_neses__2 was tache lòt fèy papye si nesesè 2 (0.49 conf)
tache_l_f_papye_si_neses__3 was tache lòt fèy papye si nesesè 3 (0.49 conf)
tache_l_f_papye_si_neses__4 was tache lòt fèy papye si nesesè 4 (0.49 conf)
tache_l_f_papye_si_neses__5 was tache lòt fèy papye si nesesè 5 (0.49 conf)
tache_l_f_papye_si_neses__6 was tache lòt fèy papye si nesesè 6 (0.49 conf)
tache_l_f_papye_si_neses__7 was tache lòt fèy papye si nesesè 7 (0.49 conf)
tache_l_f_papye_si_neses__8 was tache lòt fèy papye si nesesè 8 (0.49 conf)
tache_l_f_papye_si_neses__9 was tache lòt fèy papye si nesesè 9 (0.49 conf)
additional_sheets_paper__10 was occurred attach additional sheets of paper if necessary 1 (0.37 conf)
additional_sheets_paper__11 was occurred attach additional sheets of paper if necessary 2 (0.37 conf)
additional_sheets_paper__12 was occurred attach additional sheets of paper if necessary 3 (0.37 conf)
additional_sheets_paper__13 was occurred attach additional sheets of paper if necessary 4 (0.37 conf)
additional_sheets_paper__14 was occurred attach additional sheets of paper if necessary 5 (0.37 conf)
additional_sheets_paper__15 was occurred attach additional sheets of paper if necessary 6 (0.37 conf)
l_f_papye_si_neses__1 was lòt fèy papye si nesesè 1 (0.42 conf)
l_f_papye_si_neses__2 was lòt fèy papye si nesesè 2 (0.42 conf)
l_f_papye_si_neses__3 was lòt fèy papye si nesesè 3 (0.42 conf)
l_f_papye_si_neses__4 was lòt fèy papye si nesesè 4 (0.42 conf)
l_f_papye_si_neses__5 was lòt fèy papye si nesesè 5 (0.42 conf)
l_f_papye_si_neses__6 was lòt fèy papye si nesesè 6 (0.42 conf)
use_plaintiff_minor_children was to use against Plaintiff or the minor children (0.43 conf)
itilize_sou_pleyan_oswa_timoun_min_yo was itilize sou Pleyan an oswa sou timoun minè yo (0.52 conf)
unknown__1 was 1 (0.38 conf)
unknown__2 was 2 (0.38 conf)
unknown__3 was 3 (0.38 conf)
unknown__4 was 4 (0.38 conf)
1_2 was 1_2 (0.38 conf)
2_2 was 2_2 (0.38 conf)
3_2 was 3_2 (0.38 conf)
4_2 was 4_2 (0.38 conf)
yes__2 was Yes (0.45 conf)
no__2 was No (0.45 conf)
wi__2 was Wi (0.39 conf)
non__2 was Non (0.48 conf)
does was DOES (0.45 conf)
doe was DOES NOT (0.36 conf)
mande was MANDE (0.35 conf)
mand_e_pou_la_rem_zam was PA MANDE pou tribinal la òdone Akize a remèt zam (0.42 conf)
copy_protection_order was with a copy of the protection order (0.40 conf)
pwoteksyon was pwoteksyon an (0.32 conf)
plaintiff_exclude_defendant was Plaintiff is asking the court to evict and exclude Defendant (0.42 conf)
ap_mande_la_pou_dey was Pleyan an ap mande Tribinal la pou mete deyò epi eskli Akize (0.48 conf)
undefined__3 was undefined_3 (0.39 conf)
owned_list_owners_known was owned by list owners if known (0.36 conf)
rented_list_names_known was rented by list all names if known (0.43 conf)
owes_duty_plaintiff was Defendant owes a duty of support to Plaintiff or the minor (0.43 conf)
plaintiff_financial_losses was Plaintiff has suffered outofpocket financial losses as a result (0.38 conf)
kay_la_liste_pwopriyet_yo_si_konnen was mèt kay la liste pwopriyetè yo si yo konnen yo (0.51 conf)
lokat_liste_tout_non_yo_si_konnen was lokatè liste tout non yo si yo konnen yo (0.53 conf)
akize_blije_sip_te_pleyan_oswa_timoun_min_ayo was Akize a blije sipòte Pleyan oswa timoun minè ayo (0.44 conf)
te_ki_nan_ch_li_dif was Pleyan an te soufri pèt lajan ki soti nan pòch li difèt move (0.49 conf)
undefined__4 was undefined_4 (0.39 conf)
undefined__5 was undefined_5 (0.39 conf)
undefined__6 was undefined_6 (0.39 conf)
abuse_described was of the abuse described above (0.41 conf)
tretman_ki_dekri_anwo was tretman ki dekri anwo a (0.50 conf)
losses was Those losses are (0.42 conf)
men_p_yo was Men pèt yo (0.40 conf)
threatening_attempting_force was threatening or attempting or threatening to use physical force (0.44 conf)
eseye_oswa_menase_pou_itilize_f_fizik_kont_pleyan_akoswa was eseye oswa menase pou itilize fòs fizik kont Pleyan an akoswa (0.49 conf)
defendant_attempting_enter was prohibit Defendant from attempting to enter any temporary or (0.43 conf)
ent_di_nan_kay_p_manan was entèdi Akize a eseye antre nan nenpòt kay tanporè oswa pèmanan (0.50 conf)
children_suitable_housing was children with other suitable housing (0.41 conf)
l_lojman_ki_apwopriye was lòt lojman ki apwopriye (0.44 conf)
restrictions_contact_defendant was and place the following restrictions on contact between Defendant (0.38 conf)
min_yo_epi_mete_restriksyon_kontak_sa_ant_akize_ak_timoun was minè yo epi mete restriksyon kontak sa yo ant Akize a ak timoun (0.50 conf)
children__1 was and the children 1 (0.44 conf)
children__2 was and the children 2 (0.44 conf)
nanyo__1 was nanyo 1 (0.38 conf)
nanyo__2 was nanyo 2 (0.38 conf)
1_3 was 1_3 (0.38 conf)
2_3 was 2_3 (0.38 conf)
1_4 was 1_4 (0.38 conf)
2_4 was 2_4 (0.38 conf)
minor_children_person was or the minor children in person by telephone or in writing (0.42 conf)
oswa_timoun_min_yo_keseswa_anp_n_pa_telef_oubyen was oswa timoun minè yo keseswa anpèsòn pa telefòn oubyen (0.42 conf)
plaintiffs_relatives_petition was Plaintiffs relatives and Plaintiffs children listed in this Petition (0.45 conf)
e_ki_nan_sa_si_la was an e pitit Pleyan an ki site nan Demann sa a eksepte si tribinal la (0.47 conf)
name_non_row__5 was Name NonRow1_2 (0.44 conf)
address_adr_row__5 was Address AdrèsRow1_2 (0.35 conf)
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__1 was Relationship to Plaintiff Kisa yo ye pou Pleyan anRow1 (0.39 conf)
name_non_row__6 was Name NonRow2_2 (0.44 conf)
address_adr_row__6 was Address AdrèsRow2_2 (0.35 conf)
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__2 was Relationship to Plaintiff Kisa yo ye pou Pleyan anRow2 (0.39 conf)
name_non_row__7 was Name NonRow3_2 (0.44 conf)
address_adr_row__7 was Address AdrèsRow3_2 (0.35 conf)
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__3 was Relationship to Plaintiff Kisa yo ye pou Pleyan anRow3 (0.39 conf)
name_non_row__8 was Name NonRow4_2 (0.44 conf)
address_adr_row__8 was Address AdrèsRow4_2 (0.35 conf)
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__4 was Relationship to Plaintiff Kisa yo ye pou Pleyan anRow4 (0.39 conf)
weapons_ammunition_attachment was other weapons or ammunition listed on Attachment A to Petition (0.41 conf)
zam_oswa_minisyon_ki_endike_nan_atachman_petisyon_anba was zam oswa minisyon ki endike nan Atachman A Petisyon an anba (0.49 conf)
duration_order was for the duration of the order (0.36 conf)
tout_tan_l_la_dire was tout tan lòd la dire (0.42 conf)
minor_support_payment was the minor children including medical support and payment of (0.40 conf)
timoun_min_ayo_tankou_sip_medikal_ak_peman_lwaye was timoun minè ayo tankou sipò medikal ak peman lwaye (0.44 conf)
financial_losses_abuse was financial losses suffered as the result of the abuse to be (0.33 conf)
rezonab_li_sibi_ak_z_move_tretman_yon_montan_tribinal_la_ap was rezonab li sibi akòz move tretman an yon montan tribinal la ap (0.53 conf)
order_pay_costs_including was K Order Defendant to pay the costs of this action including (0.43 conf)
k_l_pou_fr_nan_la was K Bay Akize a lòd pou peye frè pwosedi nan tribinal la (0.49 conf)
pay_plaintiffs_attorneys was L Order Defendant to pay Plaintiffs reasonable attorneys (0.48 conf)
order_following_additional was M Order the following additional relief not listed above (0.39 conf)
l_bay_pou_fr_n_mal was L Bay Akize a lòd pou peye frè nòmal avoka Pleyan an (0.43 conf)
bay_l_pou_ki_pa_nan was M Bay lòd pou reparasyon anplis ki pa nan lis anwo a (0.51 conf)
1_5 was 1_5 (0.38 conf)
2_5 was 2_5 (0.38 conf)
3_3 was 3_3 (0.38 conf)
1_6 was 1_6 (0.38 conf)
2_6 was 2_6 (0.38 conf)
3_4 was 3_4 (0.38 conf)
grant_relief_plaintiff_court was N Grant such other relief as Plaintiff requests or the court (0.44 conf)
n_ak_de_l_jan_mande was N Akòde lòt reparasyon jan Pleyan an mande akoswa lòt (0.46 conf)
law_enforcement_agency was O Order the police sheriff or other law enforcement agency (0.48 conf)
bay_lapolis_cherif_la_oswa_l_biwo_lalwa_pou_rem was O Bay lapolis cherif la oswa lòt biwo lalwa lòd pou remèt (0.44 conf)
direct_state_municipal was P Direct the Pennsylvania State Police the municipal police (0.42 conf)
p_eta_pennsylvania_la was P Dirije Lapolis Eta Pennsylvania polis minisipal la oswa (0.50 conf)
date_dat was Date Dat (0.33 conf)
signature_siyati was Signature Siyati (0.36 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_plea
address_confidential
plaintiffs_address
last__1
last__2
defendants_address
users1_birthdate
height
sex
weight
race
eyes
weapon_involved
weapon_present_property
weapon_requested_relinquished
hair
ssn
driver_license
ex_p_date
users1_address_state
deva_n_tribina_l_premy_e_enstans
adr_pleyan_konfidansy_l
adr_pleyan_se
siyati__1
siyati__2
adr_akize
da_nesans
wo
ks
pwa
ras
zye
gen_zam_nan_ensidan
gen_zam_sou_nan_kay_la
akize_rem_zam_yo_mande
cheve
nimew_sekirit_e_sosyal
lisan_cho_f
da_espirasyon
eta
text__1
text__2
text__3
text__4
text__5
text__6
defendants_place_employment
kote_akize_ap_travay_se
check_reason_believe
la_si_ou_yon_pou_se
myself
another_person
mwen
yon_l_moun
filers_address_confidential
filers_address
adr_moun_ki_depoze_demann_lan_konfidansy_l
adr_moun_ki_depoze_demann_lan_se
undefined__1
undefined__2
parent_minor_plaintiffs
appointment_ad_minor
household_member_minor
court_incompetent_plaintiffs
paran_pleyan_min
pou_yo_k_legal_ad
adilt_ki_nan_kay_av_k_pleyan_min
pou_ki_pa_ka_li
persons_minor_children
non_tout_moun_k_ap_che
protection_abuse__1
protection_abuse__2
protection_abuse__3
kont_move_tretman__1
kont_move_tretman__2
kont_move_tretman__3
spouse_former_defendant
parent_child_defendant
current_sexual_partner
child_plaintiff
child_defendant
family_related_blood
member_related_defendant
sibling_person_defendant
check_years_old_younger
marimadanm_oswa_ansyen_akize
paran_yon_timoun_li_gen_ak_akize
patn_seksy_l_oswa_entim_akize_genyen_kounye_te
pitit_pleyan
pitit_akize
manm_fanmi_nan_san_konsangen_ak_akize
fanmi_akize_swa_pa_maryaj_oswa_alyans
fr_ak_moun_ki_gen_menm_papamaman_akize
tcheke_la_si_akize_gen_oswa_mwens
text__7
divorce
custody
support
protection_abuse__4
div
lagad_timoun
sip
pwoteksyon_kont_abi
case_filed_court_number_known__1
case_filed_court_number_known__2
te_depoze_dosye_ansanm_ak_nimewo_tribunal_la_si_w_konnen__1
te_depoze_dosye_ansanm_ak_nimewo_tribunal_la_si_w_konnen__2
defendant_criminal_court
ske_akize_te_enplike_nan_nenp_pwos_krimin_l
yes_defendant_probation
si_wi_ske_nan_lib_te
report_child_services
yon_ki_fonde_lwa_sou_vis
services_agency_report
ki_te_bay_rap_fonde_oswa_endike
names_non_yo_row__1
ages_laj_yo_row__1
unless_ki_nan_la_l__1
names_non_yo_row__2
ages_laj_yo_row__2
unless_ki_nan_la_l__2
names_non_yo_row__3
ages_laj_yo_row__3
unless_ki_nan_la_l__3
names_non_yo_row__4
ages_laj_yo_row__4
unless_ki_nan_la_l__4
names_non_yo_row__5
ages_laj_yo_row__5
unless_ki_nan_la_l__5
yes__1
no__1
wi__1
non__1
primary_shared_legal__1
primary_shared_legal__2
prensipal_pataje_legal_oswa_gad_fizik__1
prensipal_pataje_legal_oswa_gad_fizik__2
order_issued
wi_nan_ki_ak_bay_l_la
childs_name_non_timoun_nan_row__1
child_lived_moun_nan_ak_li__1
address_unless_confidential_l_row__1
kil_row__1
childs_name_non_timoun_nan_row__2
child_lived_moun_nan_ak_li__2
address_unless_confidential_l_row__2
kil_row__2
childs_name_non_timoun_nan_row__3
child_lived_moun_nan_ak_li__3
address_unless_confidential_l_row__3
kil_row__3
childs_name_non_timoun_nan_row__4
child_lived_moun_nan_ak_li__4
address_unless_confidential_l_row__4
kil_row__4
name_non_row__1
address_adr_row__1
basis_claim_rezon_demann_lan_row__1
name_non_row__2
address_adr_row__2
basis_claim_rezon_demann_lan_row__2
name_non_row__3
address_adr_row__3
basis_claim_rezon_demann_lan_row__3
name_non_row__4
address_adr_row__4
basis_claim_rezon_demann_lan_row__4
names_non_yo_row__6
ages_laj_yo_row__6
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__1
names_non_yo_row__7
ages_laj_yo_row__7
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__2
names_non_yo_row__8
ages_laj_yo_row__8
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__3
names_non_yo_row__9
ages_laj_yo_row__9
plaintiffs_relationship_children_kisa_pleyan_ye_pou_timoun_nanyo_row__4
facts_recent_incident_follows__1
facts_recent_incident_follows__2
sou_nye_ki_gen_pou_ak
dat_apepr
approximate_time
l_apepr
additional_sheets_paper__1
additional_sheets_paper__2
additional_sheets_paper__3
additional_sheets_paper__4
additional_sheets_paper__5
additional_sheets_paper__6
additional_sheets_paper__7
additional_sheets_paper__8
additional_sheets_paper__9
tache_l_f_papye_si_neses__1
tache_l_f_papye_si_neses__2
tache_l_f_papye_si_neses__3
tache_l_f_papye_si_neses__4
tache_l_f_papye_si_neses__5
tache_l_f_papye_si_neses__6
tache_l_f_papye_si_neses__7
tache_l_f_papye_si_neses__8
tache_l_f_papye_si_neses__9
additional_sheets_paper__10
additional_sheets_paper__11
additional_sheets_paper__12
additional_sheets_paper__13
additional_sheets_paper__14
additional_sheets_paper__15
l_f_papye_si_neses__1
l_f_papye_si_neses__2
l_f_papye_si_neses__3
l_f_papye_si_neses__4
l_f_papye_si_neses__5
l_f_papye_si_neses__6
use_plaintiff_minor_children
itilize_sou_pleyan_oswa_timoun_min_yo
unknown__1
unknown__2
unknown__3
unknown__4
1_2
2_2
3_2
4_2
yes__2
no__2
wi__2
non__2
does
doe
mande
mand_e_pou_la_rem_zam
copy_protection_order
pwoteksyon
plaintiff_exclude_defendant
ap_mande_la_pou_dey
undefined__3
owned_list_owners_known
rented_list_names_known
owes_duty_plaintiff
plaintiff_financial_losses
kay_la_liste_pwopriyet_yo_si_konnen
lokat_liste_tout_non_yo_si_konnen
akize_blije_sip_te_pleyan_oswa_timoun_min_ayo
te_ki_nan_ch_li_dif
undefined__4
undefined__5
undefined__6
abuse_described
tretman_ki_dekri_anwo
losses
men_p_yo
threatening_attempting_force
eseye_oswa_menase_pou_itilize_f_fizik_kont_pleyan_akoswa
defendant_attempting_enter
ent_di_nan_kay_p_manan
children_suitable_housing
l_lojman_ki_apwopriye
restrictions_contact_defendant
min_yo_epi_mete_restriksyon_kontak_sa_ant_akize_ak_timoun
children__1
children__2
nanyo__1
nanyo__2
1_3
2_3
1_4
2_4
minor_children_person
oswa_timoun_min_yo_keseswa_anp_n_pa_telef_oubyen
plaintiffs_relatives_petition
e_ki_nan_sa_si_la
name_non_row__5
address_adr_row__5
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__1
name_non_row__6
address_adr_row__6
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__2
name_non_row__7
address_adr_row__7
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__3
name_non_row__8
address_adr_row__8
relationship_plaintiff_kisa_yo_ye_pou_pleyan_row__4
weapons_ammunition_attachment
zam_oswa_minisyon_ki_endike_nan_atachman_petisyon_anba
duration_order
tout_tan_l_la_dire
minor_support_payment
timoun_min_ayo_tankou_sip_medikal_ak_peman_lwaye
financial_losses_abuse
rezonab_li_sibi_ak_z_move_tretman_yon_montan_tribinal_la_ap
order_pay_costs_including
k_l_pou_fr_nan_la
pay_plaintiffs_attorneys
order_following_additional
l_bay_pou_fr_n_mal
bay_l_pou_ki_pa_nan
1_5
2_5
3_3
1_6
2_6
3_4
grant_relief_plaintiff_court
n_ak_de_l_jan_mande
law_enforcement_agency
bay_lapolis_cherif_la_oswa_l_biwo_lalwa_pou_rem
direct_state_municipal
p_eta_pennsylvania_la
date_dat
signature_siyati

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