Here is the text we could read:
Commonwealth of Pennsylvania
Pennsylvania
ث
موك
ن
و
ل
v / دض
________________________________
Docket No / ةظفاحلا مقر: CP
20
In the Court of Common Pleas
County of _______________
________ Judicial District
ةماعلا
ة
ةمكحملا يف
ا
لا
ت
ب
د
ئ
ا
ي
_______________ ةعطاقم
__________ ةقطنم
ل
ا
ق
ض
ئ
ا
ي
ة
Petition for Expungement Pursuant to
Pa.R.Crim.P. 490
AND NOW, the petitioner avers the following and
requests that this petition for expungement pursuant to
Pa.R.Crim.P. 490 be granted for the reasons set forth
below.
Pa.R.Crim.P. 490
بجومب
بطشلل سامتلا
بطشلا سامتل
ا
لوب
ق بلطيو هاندأ ةدراولا تامولعملا ةحص سمتلملا دكؤي ،نلآاو
Pa.R.Crim.P. 490
بجومب مدقملا اذه
ةدراولا
.هاندأ
Full Name:
لماكلا مسلاا:
Address:
:
ا
ل
ع
ن
و
ا
ن
PETITIONER INFORMATION / سمتلملا تانايب
Social Security Number:
يعامتجلاا نامضلا مقر:
(
ر
ة
)
سم
ت
ع
ا
مسلا
ا
ء
مسلاا/لأا
:
DOB:
لاولا خيرات:
ة
د
Alias(es): /
CASE INFORMATION / ةيضقلا لوح تامولعم
List name, address of Judge of the Magisterial District or Philadelphia Municipal Court who accepted the guilty plea or heard the
case: /
ة
ةمكحم يضاق وأ ةيميلقلإا حلصلا ةمكحم يضاق ناونعو مسا جردأ
ب
ل
د
ي
Philadelphia
مسب ماق يذلا وأ بنذلاب رارقلإا
ا
ع
ا
ل
ق
ض
ي
ة
لوبقب ماق يذلا
udge:
يضاقلا:
Magisterial District Court Number:
ةمكحم مقر:
ة
ا
ل
ص
ل
ح
ا
لا
ل
ق
ي
م
ي
Philadelphia Municipal Court or Magisterial District Docket Number:
Philadelphia
ةمكحم
ا
ل
ص
ل
ح
ا
لا
ل
ق
ي
م
ي
ة
لا
م
أ
و
ر
ق
ف
ي
ةظفاح
Name of Arresting Agency:
ل
كولا مسا
ل
ا
ة
ا
ل
م
ع
ت
ق
ة
ةمكحم
ل
ب
د
ي
ة
ةظفاحلا
ف
ي
ر
ق
م
:
Address:
:
ا
ل
ع
ن
و
ا
ن
Date of Arrest:
علاا خيرات:
ت
ا
ق
ل
Date on Citation or Complaint:
و
أ
ةمكحملا ماما روضحل
ت
ا
ر
ي
خ
ل
سلاا
ت
د
ع
ا
ء
:
وكشلا خيرات
ى
List name and mailing address of the affiant as shown on the complaint or citation, if available: / يطعمل يديربلا ناونعلاو مسلاا ليصافت جردأ
،ءاعدتسلاا وأ ىوكشلا يف تدرو امك ةدافلاا:
إ
ن
ك
ن
ا
ت
م
ت
و
ف
ر
ة
Name of Affiant:
يطعم مسا:
لا
ا
ا
ف
د
ة
Address:
:
ا
ل
ع
ن
و
ا
ن
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): /
مزل اذإ ةيفاضإ تاحفص قافرا
ىجري( اهنم لك تمسح فيكو ،ماهتلاا ةحئلا يف تدرو ام
،
ا
ك
طش بولطملا
ب
ه
م
جردأ
ا
ل
ت
ه
رملاا
)
PA Statute
(Title)
نوناق
ب
ن
س
ل
ف
ا
ن
ي
ا
مسلاا(
)
Statute Description
نوناقلا فصو
Section
ل
ا
ب
ن
د
Subsection
يعرفلا دنبلا
Disposition
مسحلا
Counts
مهتلا ددع
Grade
ةجردلا
If the sentence imposed included a fine, costs or restitution, has the amount due been paid? / وأ فيلاكت وأ ةمارغ ةضورفملا ةبوقعلا تلمش اذا
؟قحتسملا غلبملا عفد مت له ،ضيوعت Yes/معن No/ لا
J
List the reason(s) for the expungement (please attach additional sheet(s) of paper if necessary): / قافرإ ىجري( بطشلا بابسأ/ببس جردأ
رملأا مزل نإ ةيفاضإ تاحفص
)
Pennsylvania
ي
60
و
م
ق
ب
ل
ا
ت
ر
ي
خ
ت
ق
د
ي
م
ا
لا
ت
ل
م
ا
س
نوضغ يف اهيلع تلصح يتلاو
I have attached a copy of my Pennsylvania State Police Criminal History which I have obtained within 60 days before filing this
petition. /
وسلا ةحئلا نع ةخسن قفرأ مل
ب
ا
ق
I have not attached a copy of my Pennsylvania State Police Criminal History. State reason(s) below: /
لاو ةطرش نم ةيمارجلاا قباوسلا ةحئلا نع ةخسن تقفرأ دقل
ة
ي
:
ه
سلأا/ببسلا ركذا .
ا
ب
ب
أ
د
ا
ن
لاو
ة
ي
ةطرش نم ةيمارجلاا
Pennsylvania
When 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.
.ثلونموكلا يماحمل ةخسن ميدقت سمتلملا ىلع ،مكاحملا ملق ىدل سامتللاا اذه ميدقت دنع
اذه يف ةدراولا قئاقحلا نأ ىلع دكؤأ ،هاندأ عقوملا سمتلملا ،انأ
يصخشلا يريدقتو يتامولعمو يتفرعم
بسحب ةيقيقحو ةحيحص يه سامتللاا
مسقب ةعوفشم ريغ ةبذاك تاحيرصت ميدقتب ةقلعتملا تابوقعلل ةعضاخ يهو
18 Pa.C.S § 4904
تاطلسلل
.
بجومب اذهو
Signature of Petitioner
سمتلملا عيقوت
Date
ا
ل
ت
ا
ر
ي
خ
AOPC Form Updated Rev 03/09/12
Arabic Petition for Expungement Pursuant to Pa.R.Crim.P. 490
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):
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.
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__1
county__2
md_j_number
Suggested Screen 1:
Suggested Screen 2:
docket_seg__1
docket_seg__2
docket_seg__3
docket_seg__4
cp_docket_number
Suggested Screen 3:
Suggested Screen 4:
addr__1
addr__2
judge_addr__1
judge_addr__2
affiant_addr__1
affiant_addr__2
Suggested Screen 5:
aliases__1
aliases__2
aliases__3
aliases__4
aliases__5
Suggested Screen 6:
Suggested Screen 7:
addr_city
judge_addr_city
judge_addr_state
Suggested Screen 8:
defendant
date_arrest
date_complaint
Suggested Screen 9:
Suggested Screen 10:
addr_state
affiant_addr_city
affiant_addr_state
Suggested Screen 11:
addr_zip
judge_addr_zip
affiant_addr_zip
Suggested Screen 12:
disposition_row__1
disposition_row__2
disposition_row__3
disposition_row__4
disposition_row__5
Suggested Screen 13:
social_security_number
name_arresting_agency
statute_description_row__1
statute_description_row__2
statute_description_row__3
statute_description_row__4
statute_description_row__5
Suggested Screen 14:
p_statute_title_row__1
section_row__1
p_statute_title_row__2
section_row__2
p_statute_title_row__3
section_row__3
p_statute_title_row__4
section_row__4
p_statute_title_row__5
section_row__5
Suggested Screen 15:
subsection_row__1
counts_row__1
subsection_row__2
counts_row__2
subsection_row__3
counts_row__3
subsection_row__4
counts_row__4
subsection_row__5
counts_row__5
Suggested Screen 16:
grade_row__1
grade_row__2
grade_row__3
grade_row__4
grade_row__5
Suggested Screen 17:
Suggested Screen 18:
Suggested Screen 19:
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