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            "text": "CONFIDENTIAL INFORMATION FORM",
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            "text": "Case Records Public Access Policy of the Unified Judicial System of Pennsylvania\n204 Pa. Code § 213.81\nwww.pacourts.us/public-records",
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            "text": "(Party name as displayed in case caption)",
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            "text": "V_{S}."
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            "text": "This form is associated with the pleading titled ___, dated___, ___."
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            "text": "Pursuant to the Case Records Public Access Policy of the Unified Judicial System of Pennsylvania, the Confidential Information Form shall accompany a filing where confidential information is required by law, ordered by the court, or otherwise necessary to effect the disposition of a matter. This form, and any additional pages, shall remain confidential, except that it shall be available to the parties, counsel of record, the court, and the custodian. This form, and any additional pages, must be served on all unrepresented parties and counsel of record."
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                    "text": "Alternative Reference:SSN 2",
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                        "colspan": 1
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                },
                {
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                    "text": "(full name of adult)ORThis information pertains to a minor with the initials of ___ and the full name of",
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                                "label": "second minor with the initials of",
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                    "text": "Financial Account Number (FAN):",
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                    "children": [
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                                "label": "Financial Account Number of second person (format: numeric)",
                                "pdf_field_name": "Financial Account Number2",
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                    "type": "table_cell",
                    "bbox": {
                        "l": 388.32,
                        "t": 189.4691,
                        "r": 544.8,
                        "b": 155.0618
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                    "text": "Alternative Reference:FAN 2",
                    "attrs": {
                        "row": 7,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
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                },
                {
                    "id": "p6.16.24",
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                    "type": "table_cell",
                    "bbox": {
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                        "r": 231.84,
                        "b": 120.6545
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                    "text": "",
                    "attrs": {
                        "row": 8,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1
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                    "children": [
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                                "r": 226.68,
                                "b": 129.054
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "full name of additional minor",
                                "pdf_field_name": "full name of minor2",
                                "source": "acroform",
                                "row": 8,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1
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                    ]
                },
                {
                    "id": "p6.16.25",
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                    "type": "table_cell",
                    "bbox": {
                        "l": 231.84,
                        "t": 155.0618,
                        "r": 388.32,
                        "b": 120.6545
                    },
                    "text": "Driver License Number (DLN):",
                    "attrs": {
                        "row": 8,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1
                    },
                    "children": [
                        {
                            "id": "p6.16.25.1",
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                                "l": 237.72,
                                "t": 145.36,
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                                "b": 128.8
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Drivers License Number of second person (format: numeric)",
                                "pdf_field_name": "Drivers License Number2",
                                "source": "acroform",
                                "row": 8,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1
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                        }
                    ]
                },
                {
                    "id": "p6.16.26",
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                    "type": "table_cell",
                    "bbox": {
                        "l": 388.32,
                        "t": 155.0618,
                        "r": 544.8,
                        "b": 120.6545
                    },
                    "text": "Alternative Reference:DLN 2",
                    "attrs": {
                        "row": 8,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
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                },
                {
                    "id": "p6.16.27",
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                    "type": "table_cell",
                    "bbox": {
                        "l": 75.36,
                        "t": 120.6545,
                        "r": 231.84,
                        "b": 86.2473
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                    "text": "(full name of minor)and date of birth: ___",
                    "attrs": {
                        "row": 9,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1
                    },
                    "children": [
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                            "id": "p6.16.27.1",
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                                "l": 172.36,
                                "t": 110.92,
                                "r": 222.28,
                                "b": 94.36
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "and date of birth of second minor",
                                "pdf_field_name": "Minors' Date of Birth2",
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                                "row": 9,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1
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                        }
                    ]
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                {
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                    "order": 61,
                    "type": "table_cell",
                    "bbox": {
                        "l": 231.84,
                        "t": 120.6545,
                        "r": 388.32,
                        "b": 86.2473
                    },
                    "text": "State of Issuance:",
                    "attrs": {
                        "row": 9,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1
                    },
                    "children": [
                        {
                            "id": "p6.16.28.1",
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                                "t": 110.92,
                                "r": 382.56,
                                "b": 94.36
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "State of Issuance:",
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                                "source": "acroform",
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                    "order": 63,
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                    "bbox": {
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                        "r": 544.8,
                        "b": 51.84
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                    "text": "Alternative Reference:SID 2",
                    "attrs": {
                        "row": 9,
                        "col": 2,
                        "rowspan": 2,
                        "colspan": 1
                    }
                },
                {
                    "id": "p6.16.30",
                    "order": 64,
                    "type": "table_cell",
                    "bbox": {
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                    "text": "",
                    "attrs": {
                        "row": 10,
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                },
                {
                    "id": "p6.16.31",
                    "order": 65,
                    "type": "table_cell",
                    "bbox": {
                        "l": 231.84,
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                        "b": 51.84
                    },
                    "text": "State Identification Number (SID):",
                    "attrs": {
                        "row": 10,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1
                    },
                    "children": [
                        {
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                            "text": "",
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                                "field_kind": "text",
                                "label": "State Identification Number of second person (format: numeric)",
                                "pdf_field_name": "State Identification Number2",
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                                "colspan": 1
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                        }
                    ]
                }
            ]
        },
        {
            "id": "p6.17",
            "order": 67,
            "type": "footer",
            "bbox": {
                "l": 70.56,
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                "r": 131.52,
                "b": 26.4
            },
            "text": "Rev. 7/2018",
            "attrs": {
                "block_label": "footer"
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        },
        {
            "id": "p6.18",
            "order": 68,
            "type": "footer",
            "bbox": {
                "l": 182.4,
                "t": 43.68,
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                "b": 27.12
            },
            "text": "THIS FORM IS CONFIDENTIAL",
            "attrs": {
                "block_label": "footer"
            }
        }
    ],
    "excluded_furniture": {
        "first": [],
        "last": []
    }
}