{ "document_id": 10276, "page": 36, "width_pt": 612, "height_pt": 792, "rotation": 0, "pipeline_version": "paddleocr-vl-1.6+paul-48", "engine": "paddleocr_vl", "source_run_id": 10387, "item_count": 33, "counts_by_type": { "form_field": 14, "table": 1, "table_cell": 1, "text": 17 }, "build_ms": 2, "items": [ { "id": "p36.1", "order": 1, "type": "text", "bbox": { "l": 47.76, "t": 740.64, "r": 553.2, "b": 684.96 }, "text": "8a. Are you aware of any pending investigations of abuse of either party or members of either party’s household by any children & youth services agency, child protective services, or general protective services agency, or the equivalent agency in another jurisdiction, concerning the children in this custody case or any other children?" }, { "id": "p36.2", "order": 2, "type": "text", "bbox": { "l": 84.48, "t": 668.4, "r": 178.08, "b": 654.96 }, "text": "YES NO", "children": [ { "id": "p36.2.1", "order": 3, "type": "form_field", "bbox": { "l": 109.38, "t": 669.227, "r": 124.775, "b": 653.832 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "YES □", "pdf_field_name": "Check BoxS(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.2", "text_offset": 0, "text_span": 0 } } ] }, { "id": "p36.3", "order": 4, "type": "form_field", "bbox": { "l": 176.346, "t": 669.227, "r": 191.369, "b": 653.832 }, "text": "", "attrs": { "field_kind": "checkbox", "label": "NO □", "pdf_field_name": "Check BoxT(PlCH)", "source": "acroform" } }, { "id": "p36.4", "order": 5, "type": "text", "bbox": { "l": 47.76, "t": 639.84, "r": 396.96, "b": 625.2 }, "text": "8b. If you answered YES to question 8a, please complete the following:" }, { "id": "p36.5", "order": 6, "type": "text", "bbox": { "l": 47.76, "t": 612.48, "r": 538.56, "b": 597.36 }, "text": "Name of agency where investigation is pending: ___", "children": [ { "id": "p36.5.1", "order": 7, "type": "form_field", "bbox": { "l": 302.4, "t": 627, "r": 536.4, "b": 600.48 }, "text": "", "attrs": { "field_kind": "text", "label": "Name of agency where investigation is pending: ___", "pdf_field_name": "NameofAgency(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.5", "text_offset": 47, "text_span": 3 } } ] }, { "id": "p36.6", "order": 8, "type": "text", "bbox": { "l": 47.52, "t": 584.88, "r": 538.32, "b": 569.76 }, "text": "Status of the investigation: ___", "children": [ { "id": "p36.6.1", "order": 9, "type": "form_field", "bbox": { "l": 194.4, "t": 599.4, "r": 536.4, "b": 572.88 }, "text": "", "attrs": { "field_kind": "text", "label": "Status of the investigation: ___", "pdf_field_name": "Status of the investigation(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.6", "text_offset": 29, "text_span": 3 } } ] }, { "id": "p36.7", "order": 10, "type": "text", "bbox": { "l": 48.96, "t": 557.76, "r": 540.96, "b": 541.2 }, "text": "The circumstances surrounding the investigation:" }, { "id": "p36.8", "order": 11, "type": "table", "bbox": { "l": 49.44, "t": 540.24, "r": 540.48, "b": 441.6 }, "text": "", "attrs": { "block_label": "table", "n_rows": 1, "n_cols": 1, "integrity": { "skipped": "no_text_layer" } }, "children": [ { "id": "p36.8.1", "order": 12, "type": "table_cell", "bbox": { "l": 49.44, "t": 540.24, "r": 540.48, "b": 441.6 }, "text": "", "attrs": { "row": 0, "col": 0, "rowspan": 1, "colspan": 1 }, "children": [ { "id": "p36.8.1.1", "order": 13, "type": "form_field", "bbox": { "l": 50.5972, "t": 541.246, "r": 541.012, "b": 442.607 }, "text": "", "attrs": { "field_kind": "text", "pdf_field_name": "Circumstances3(PlCH)", "source": "acroform", "row": 0, "col": 0, "rowspan": 1, "colspan": 1 } } ] } ] }, { "id": "p36.9", "order": 14, "type": "text", "bbox": { "l": 47.52, "t": 402.72, "r": 559.92, "b": 360.48 }, "text": "I verify that the information above is true and correct to the best of my knowledge, information or belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities." }, { "id": "p36.10", "order": 15, "type": "text", "bbox": { "l": 49.2, "t": 327.84, "r": 178.56, "b": 317.76 }, "text": "___" }, { "id": "p36.11", "order": 16, "type": "text", "bbox": { "l": 48.72, "t": 318.96, "r": 178.08, "b": 306 }, "text": "DATE", "children": [ { "id": "p36.11.1", "order": 17, "type": "form_field", "bbox": { "l": 50.4, "t": 348.24, "r": 176.4, "b": 321.72 }, "text": "", "attrs": { "field_kind": "text", "label": "DATE", "pdf_field_name": "DATE(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.11" } } ] }, { "id": "p36.12", "order": 18, "type": "text", "bbox": { "l": 264.48, "t": 329.52, "r": 484.08, "b": 318.48 }, "text": "___", "children": [ { "id": "p36.12.1", "order": 19, "type": "form_field", "bbox": { "l": 266.4015, "t": 333.7339, "r": 482.4015, "b": 320.4449 }, "text": "", "attrs": { "field_kind": "text", "source": "blank_line" } } ] }, { "id": "p36.13", "order": 20, "type": "text", "bbox": { "l": 263.28, "t": 320.4, "r": 483.6, "b": 278.4 }, "text": "SIGNATURE", "children": [ { "id": "p36.13.1", "order": 21, "type": "form_field", "bbox": { "l": 266.4, "t": 306.84, "r": 482.4, "b": 280.32 }, "text": "", "attrs": { "field_kind": "text", "label": "SIGNATURE", "pdf_field_name": "Printed Name(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.13" } } ] }, { "id": "p36.14", "order": 22, "type": "text", "bbox": { "l": 263.52, "t": 278.16, "r": 484.56, "b": 207.84 }, "text": "(Printed Name)\n___", "children": [ { "id": "p36.14.1", "order": 23, "type": "form_field", "bbox": { "l": 266.4, "t": 265.44, "r": 482.4, "b": 238.92 }, "text": "", "attrs": { "field_kind": "text", "label": "(Printed Name)\n___", "pdf_field_name": "AddressLine1(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.14" } } ] }, { "id": "p36.15", "order": 24, "type": "text", "bbox": { "l": 264.96, "t": 208.56, "r": 315.12, "b": 195.6 }, "text": "(Address)", "children": [ { "id": "p36.15.1", "order": 25, "type": "form_field", "bbox": { "l": 266.4, "t": 237.84, "r": 482.4, "b": 211.32 }, "text": "", "attrs": { "field_kind": "text", "label": "(Address)", "pdf_field_name": "AddressLine2(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.15" } } ] }, { "id": "p36.16", "order": 26, "type": "text", "bbox": { "l": 264.96, "t": 181.2, "r": 420.48, "b": 166.8 }, "text": "( )___", "children": [ { "id": "p36.16.1", "order": 27, "type": "form_field", "bbox": { "l": 316.44, "t": 196.44, "r": 418.44, "b": 169.92 }, "text": "", "attrs": { "field_kind": "text", "label": "(_______)_________________", "pdf_field_name": "HomePhone(PlCH)", "source": "acroform" } } ] }, { "id": "p36.17", "order": 28, "type": "text", "bbox": { "l": 264.96, "t": 167.04, "r": 421.92, "b": 153.6 }, "text": "(Home Phone)", "children": [ { "id": "p36.17.1", "order": 29, "type": "form_field", "bbox": { "l": 270.36, "t": 196.44, "r": 312.36, "b": 169.92 }, "text": "", "attrs": { "field_kind": "text", "label": "(Home Phone)", "pdf_field_name": "AreaCode1(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.17" } } ] }, { "id": "p36.18", "order": 30, "type": "text", "bbox": { "l": 264.72, "t": 140.4, "r": 420.24, "b": 126 }, "text": "( )", "children": [ { "id": "p36.18.1", "order": 31, "type": "form_field", "bbox": { "l": 316.44, "t": 155.04, "r": 418.44, "b": 128.52 }, "text": "", "attrs": { "field_kind": "text", "label": "(_______)_________________", "pdf_field_name": "WorkPhone(PlCH)", "source": "acroform" } } ] }, { "id": "p36.19", "order": 32, "type": "text", "bbox": { "l": 264.96, "t": 125.28, "r": 420.96, "b": 112.56 }, "text": "(Work Phone)", "children": [ { "id": "p36.19.1", "order": 33, "type": "form_field", "bbox": { "l": 270.36, "t": 155.04, "r": 312.36, "b": 128.52 }, "text": "", "attrs": { "field_kind": "text", "label": "(Work Phone)", "pdf_field_name": "AreaCode2(PlCH)", "source": "acroform", "label_source": "parent_text", "label_ref": "p36.19" } } ] } ], "excluded_furniture": { "first": [], "last": [] } }