Here is the text we could read:
Social Security Number:
ខលខរនតិរុខរងគម៖
DOB:
វខនងៃឆនាំក្ំខណើត៖
Alias(es): / ខ ្ាេះខស្រា៖
Docket No / រំណ ំខរឿងខលខ៖ CP
20
Commonwealth of Pennsylvania
នវែលននរដ្ឋ Pennsylvania
ម
ុ
ំ
ខ
v / ទល់នឹង
________________________________
In the Court of Common Pleas
County of _______________
________ Judicial District
ងតុលាការ Common Pleas
ក្
ុ
ន
ខ ានធី _______________
________ តុលាការស្រុក្
Petition for Expungement Pursuant to
Pa.R.Crim.P. 790
ញត្ត
ិស្ន
ុំការល បស ា្ ស្្បតាម
ើ្
Pa.R.Crim.P. 790
AND NOW, the petitioner avers the following and
requests that this petition for expungement pursuant to
Pa.R.Crim.P. 790 be granted for the reasons set forth
below.
ឥឡូែខនេះ អ្នក្ដាក្់ញតត
ការលុបខ ារខនេះ ស្របតាម Pa.R.Crim.P. 790 ខដាយសារ
មូលខេតុដ្ូច ាងខស្កាម។
PETITIONER INFORMATION / ព័ត្៌មានអ្នកដាក់ញត្តិ
ិរូមអ្េះអាងដ្ូច ាងខស្កាម និងខរន
ើឲ្យផ្ដល់
Full Name:
ខ ្ាេះខេញ៖
Address:
អារយដឋាន៖
CASE INFORMATION / ព័ត្៌មានអ្ុំពីសរឿងកដី
List name, address of the Judge of the Court of Common Pleas or Philadelphia Municipal Court who accepted the guilty plea or
heard the case: រាយខ ្ាេះ, អារយដឋានរបរ់ខ ាស្ក្មននតុលាការ Common Pleas ឬក្៏តុលាការស្ក្ុង Philadelphia វដ្លបានទទួលយក្
ចខមលើយរបរ់ចុងខ ាទអ្ំេីេិរុទធភាេ ឬក្៏បានខបើក្រែនាការខលើខរឿងក្ដីខនាេះ៖
Judge:
ខ ាស្ក្ម៖
Address:
អារយដឋាន៖
Offense Tracking Number (OTN):
ខលខតាមដានបទខល្ើរ (OTN)៖
Philadelphia Municipal Court or Court of Common Pleas
Docket Number: / តុលាការស្ក្ុង Philadelphia ឬតុលាការ
Common Pleas រំណ ំខរឿងខលខ៖
Name of Arresting Agency:
ខ ្ាេះរបរ់ភនាក្់ងារឃាត់ខលួន៖
Date of Arrest:
Date on Complaint:
កាលបរិខចេទខលើបណដឹង៖
កាលបរិខចេទឃាត់ខលួន៖
List name and mailing address of the affiant as shown on the complaint, if available: / រាយខ ្ាេះនិងអារយដឋាននស្បរណីយ៍របរ់អ្នក្វងលង
រ ចា ដ្ូចបានបងហាញខលើបណដឹង ខបើមាន៖
Name of Affiant:
ខ ្ាេះអ្នក្វងលងរ ចា៖
អារយដឋាន៖
List specific charges, as they appear on the charging document, to be expunged and the disposition of each charge (please attach
additional sheet(s) of paper if necessary): / រាយការខ ាទស្បកាន់ជាក្់លាក្់ ដ្ូចវដ្លេួក្វាបងហាញខលើឯក្សារខ ាទស្បកាន់ វដ្លស្តូែលុបខ ាល
ងការលុបខ ាលនូែការខ ាទស្បកាន់នីមួយៗ (រូមភជាប់រនលឹក្ស្ក្ដារបវនែម ខបើ ាំបាច់)៖
ន
ិ
PA Statute
(Title)
ចាប់ PA
ណងខ ើង)
(
ច
ំ
Statute Description
េណ៌នាអ្ំេីចាប់
ិ
េ
Disposition
ការលុបខ ាល
Subsection
អ្នុមាស្តា
Section
មាស្តា
Grade
ាក្់
ន
ថ្
ខខ ាទ
ស្បកាន់
Address:
Counts
If the sentence imposed included a fine, costs or restitution, has the amount due been paid? / ខបើការកាត់ខ ារខនាេះ រួមមានការផាក្េិន័យ
ខសាេ ុយចំណាយខផ្េងៗ ឬរំណង ខតើបានបង់ចំនួនទឹក្ស្បាក្់វដ្លស្តូែបង់ខនាេះខេើយឬខ ា? Yes/បាទ/ ារ No/ខទ
ist the reason(s) for the expungement (please attach additional sheet(s) of paper if necessary): / រាយមូលខេតុរស្មាប់ការលុបខ ារ
មភជាប់រនលឹក្ស្ក្ដារបវនែម ខបើ ាំបាច់)៖
ូ
រ
(
I have attached a copy of my Pennsylvania State Police Criminal History which I have obtained within 60 days before filing this
petition. / ខ្ុំបានភជាប់រំខ ាចមលងននស្បែតតិខល្ើររបរ់ខ្ុំ េីប ូលីរននរដ្ឋ Pennsylvania វដ្លខ្ុំបានទទួលក្នុងខេល 60នងៃ មុនខេលដាក្់ញតតិខនេះ។
I have not attached a copy of my Pennsylvania State Police Criminal History. State reason(s) below: / ខ្ុំមិនបានភជាប់រំខ ាចមលងនន
ស្បែតតិខល្ើររបរ់ខ្ុំេីប ូលីរននរដ្ឋ Pennsylvania ខទ។ រូមបញ្ជាក្់មូលខេតុ ាងខស្កាម៖
hen this petition is filed with the Clerk of Courts, the
petitioner shall serve a copy upon the attorney for the
Commonwealth.
I, the undersigned petitioner, avers that the
facts set forth in this petition are true and correct to
the best of my personal knowledge or information
and belief, and are made subject to the penalties of
unsworn falsification to authorities under 18 Pa.C.S §
4904.
ស ាសពលញត្ត
សនេះស្ត្ូវបានដាក់ស ាស្កឡាបញ្ជ
បស្ម ង្ុំស ាចមលងមួយចាប់ស្បគល់ឲ្យសមធាវីខុំមិនវវល។
ីននត្ លាការ អ្នកដាក់ញត្ត
ិស្ត្ូវ
ខ
ំ វដ្លជាអ្នក្ដាក្់ញតត
ិនិងជាេតែខលខី រូមអ្េះអាងថ្ា
េ
័ត៌មានវដ្លបានខលើក្ខឡើងក្ន
ុងញតត
ិខនេះគឺេិតនិងស្តឹមស្តូែ ខស្កាម
ការយល់ដ្ឹង ឬេ័ត៌មាននិង ំខនឿលអបំផ្ុតរបរ់ខ្
ំ ខេើយស្តូែបានខធវ
ុននការេិន័យពាក្់េ័នធនឹងការផ្ដល់នូែរក្ខ
ខស្កាមក្ម្ែតែ
ដ្ល់អាជ្ាធរ ខស្កាម 18 Pa.C.S § 4904។
ីក្ម្វក្លងកលាយ
Signature of Petitioner
ហត្ថសលខារប្់អ្នកដាក់ញត្តិ
Date
កាលបរិសចេទ
L
W
AOPC Form Updated Rev 3/09/12
ិ
្
ុ
ុ
ើ
Khmer Petition for Expungement Pursuant to Pa.R.Crim.P. 790
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): 2
- Fields(s): 77
- Average fields per page: 38
- Reading Level: Grade 10
- LIST Grouping(s):
CO-00-00-00-00, CO-07-00-00-00.
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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.
county__1 was CountyOf (0.58 conf)district__1 was District# (0.27 conf)defendant was Defendant (1.00 conf)docket_seg__1 was DocketSeg1 (0.31 conf)docket_seg__2 was DocketSeg2 (0.31 conf)docket_seg__3 was DocketSeg3 (0.31 conf)docket_seg__4 was DocketSeg4 (0.31 conf)county__2 was CountyOf_T (0.38 conf)district__2 was District#_T (0.31 conf)full_name was Full Name (0.33 conf)addr__1 was Addr1 (0.35 conf)addr__2 was Addr2 (0.35 conf)addr_city was AddrCity (0.36 conf)addr_state was AddrState (0.44 conf)addr_zip was AddrZip (0.33 conf)users1_birthdate was DOB (1.00 conf)social_security_number was Social Security Number (0.38 conf)aliases__1 was Aliases1 (0.35 conf)aliases__2 was Aliases2 (0.35 conf)aliases__3 was Aliases3 (0.35 conf)aliases__4 was Aliases4 (0.35 conf)aliases__5 was Aliases5 (0.35 conf)judge was Judge (0.39 conf)md_j_number was MDJ Number (0.45 conf)judge_addr__1 was JudgeAddr1 (0.39 conf)judge_addr__2 was JudgeAddr2 (0.39 conf)judge_addr_city was JudgeAddrCity (0.38 conf)judge_addr_state was JudgeAddrState (0.42 conf)judge_addr_zip was JudgeAddrZip (0.35 conf)cp_docket_number was CPDocketNumber (0.31 conf)name_arresting_agency was Name of Arresting Agency (0.44 conf)date_arrest was Date of Arrest (0.47 conf)date_complaint was Date on Complaint (0.38 conf)name_affiant was Name of Affiant (0.39 conf)affiant_addr__1 was AffiantAddr1 (0.35 conf)affiant_addr__2 was AffiantAddr2 (0.35 conf)affiant_addr_city was AffiantAddrCity (0.36 conf)affiant_addr_state was AffiantAddrState (0.44 conf)affiant_addr_zip was AffiantAddrZip (0.33 conf)p_statute_title_row__1 was PA Statute TitleRow1 (0.34 conf)section_row__1 was SectionRow1 (0.27 conf)subsection_row__1 was SubsectionRow1 (0.45 conf)statute_description_row__1 was Statute DescriptionRow1 (0.35 conf)counts_row__1 was CountsRow1 (0.45 conf)grade_row__1 was GradeRow1 (0.31 conf)disposition_row__1 was DispositionRow1 (0.46 conf)p_statute_title_row__2 was PA Statute TitleRow2 (0.34 conf)section_row__2 was SectionRow2 (0.27 conf)subsection_row__2 was SubsectionRow2 (0.45 conf)statute_description_row__2 was Statute DescriptionRow2 (0.35 conf)counts_row__2 was CountsRow2 (0.45 conf)grade_row__2 was GradeRow2 (0.31 conf)disposition_row__2 was DispositionRow2 (0.46 conf)p_statute_title_row__3 was PA Statute TitleRow3 (0.34 conf)section_row__3 was SectionRow3 (0.27 conf)subsection_row__3 was SubsectionRow3 (0.45 conf)statute_description_row__3 was Statute DescriptionRow3 (0.35 conf)counts_row__3 was CountsRow3 (0.45 conf)grade_row__3 was GradeRow3 (0.31 conf)disposition_row__3 was DispositionRow3 (0.46 conf)p_statute_title_row__4 was PA Statute TitleRow4 (0.34 conf)section_row__4 was SectionRow4 (0.27 conf)subsection_row__4 was SubsectionRow4 (0.45 conf)statute_description_row__4 was Statute DescriptionRow4 (0.35 conf)counts_row__4 was CountsRow4 (0.45 conf)grade_row__4 was GradeRow4 (0.31 conf)disposition_row__4 was DispositionRow4 (0.46 conf)p_statute_title_row__5 was PA Statute TitleRow5 (0.34 conf)section_row__5 was SectionRow5 (0.27 conf)subsection_row__5 was SubsectionRow5 (0.45 conf)statute_description_row__5 was Statute DescriptionRow5 (0.35 conf)counts_row__5 was CountsRow5 (0.45 conf)grade_row__5 was GradeRow5 (0.31 conf)disposition_row__5 was DispositionRow5 (0.46 conf)reason_expungement was ReasonForExpungement (0.47 conf)reason_missing_history was ReasonForMissingHistory (0.43 conf)date_sig was Date of Sig (0.34 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
county__1county__2md_j_number
Suggested Screen 1:
docket_seg__1docket_seg__2docket_seg__3docket_seg__4cp_docket_number
Suggested Screen 2:
Suggested Screen 3:
Suggested Screen 4:
addr__1addr__2judge_addr__1judge_addr__2affiant_addr__1affiant_addr__2
Suggested Screen 5:
aliases__1aliases__2aliases__3aliases__4aliases__5
Suggested Screen 6:
Suggested Screen 7:
addr_cityjudge_addr_cityjudge_addr_state
Suggested Screen 8:
defendantdate_arrestdate_complaint
Suggested Screen 9:
Suggested Screen 10:
addr_stateaffiant_addr_cityaffiant_addr_state
Suggested Screen 11:
addr_zipjudge_addr_zipaffiant_addr_zip
Suggested Screen 12:
social_security_numbername_arresting_agencystatute_description_row__1statute_description_row__2statute_description_row__3statute_description_row__4statute_description_row__5
Suggested Screen 13:
disposition_row__1disposition_row__2disposition_row__3disposition_row__4disposition_row__5
Suggested Screen 14:
p_statute_title_row__1section_row__1p_statute_title_row__2section_row__2p_statute_title_row__3section_row__3p_statute_title_row__4section_row__4p_statute_title_row__5section_row__5
Suggested Screen 15:
grade_row__1grade_row__2grade_row__3grade_row__4grade_row__5
Suggested Screen 16:
subsection_row__1counts_row__1subsection_row__2counts_row__2subsection_row__3counts_row__3subsection_row__4counts_row__4subsection_row__5counts_row__5
Suggested Screen 17:
Suggested Screen 18:
Suggested Screen 19:
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