REQUEST FOR DETERMINATION 
OF ABANDONMENT 
DEMANN POU DETÈMINASYON 
POU ABANDON  

 

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V. / Kont 
 

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Docket No./Nimewo Lis Dosye: 

Case Filed/Ka a Ranpli: 

 

 

   

 

O THE MAGISTERIAL DISTRICT JUDGE: 

POU JIJ DISTRI MAJISTRAL LA: 
 

The Landlord(s) in the above-captioned matter requests 

that you issue a Determination of Abandonment for the 
manufactured home and property located at: 

Mèt kay la (yo) ki endike nan afè anwo a mande pou w 
bay yon Detèminasyon pou Abandon pou kay prefabrike ak 
pwopriyete ki chita kò li nan: 

selon sa ki vini annapre a: 
 

  1.  The resident has been absent from the home for at least 

  1.  Rezidan an te absan nan kay la pandan omwen 30 jou; 

  2.  The resident has not paid rent for at least 30 days from 

the date it was due; and, one or more of the following 

  2.  Rezidan an pa t peye kòb lwaye a pandan omwen 30 jou 

apati dat li te bout la; epi, youn oswa plis nan sikonstans 

circumstances exists: 

  a.  Termination of electric or water service to the 

home, and other utility or payment of services to 

the community owner has occurred; 

  b.  Home insurance has been canceled; 

from the home; or 

  d.  Other indicia of abandonment: 

sa yo egziste: 

  a.  Yo koupe kouran oswa sèvis dlo a nan kay la, ak 

lòt sèvis piblik oswa yo te peye pwopriyetè 

kominotè a sèvis yo; 

  b.  Yo anile asirans kay la; 

la; oswa 

  d.  Lòt endis abandon: 

  c.  Most or all personal property have been removed 

  c.  Yo retire pifò oswa tout byen pèsonèl yo nan kay 

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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 and 
documents. 

Mwen sètifye demann mwen depoze sa a konfòme ak 
dispozisyon Politik Aksè Piblik nan Dosye Ka Sistèm Jidisyè 
Inifye Pennsylvania a ki egzije yo depoze enfòmasyon 
konfidansyèl yon fason diferan ak fason yo depoze dokiman 
ak enfòmasyon ki pa konfidansyèl yo. 

Date / Dat 

Signature of Landlord / Siyati Mèt Kay la 

 

 

KONTE 

ag. Dist. No: 

Nimewo Distri Majistral: 
MDJ Name: 
Non Jij Distri Majistral la: 

ddress: 

Adrès: 

elephone: 

Telefòn: 
 

 

 
based upon the following: 
 

30 days; 

  M

  A

    T

        T

 

     

 

 

COMMONWEALTH OF PENNSYLVANIA  

COUNTY OF 

KOMINOTE PENNSYLVANIA