{
    "document_id": 16164,
    "page": 11,
    "width_pt": 612,
    "height_pt": 792,
    "rotation": 0,
    "pipeline_version": "paddleocr-vl-1.6+paul-48",
    "engine": "paddleocr_vl",
    "source_run_id": 16275,
    "item_count": 75,
    "counts_by_type": {
        "figure": 1,
        "footer": 2,
        "form_field": 32,
        "header": 1,
        "table": 1,
        "table_cell": 37,
        "title": 1
    },
    "build_ms": 8,
    "items": [
        {
            "id": "p11.1",
            "order": 1,
            "type": "header",
            "bbox": {
                "l": 70.56,
                "t": 773.04,
                "r": 181.92,
                "b": 726.48
            },
            "text": "CONFIDENTIAL INFORMATION FORM",
            "attrs": {
                "block_label": "header"
            },
            "level": 2
        },
        {
            "id": "p11.2",
            "order": 2,
            "type": "figure",
            "bbox": {
                "l": 271.2,
                "t": 775.92,
                "r": 325.92,
                "b": 738
            },
            "text": "",
            "attrs": {
                "role": "page_header",
                "block_label": "header_image"
            }
        },
        {
            "id": "p11.3",
            "order": 3,
            "type": "title",
            "bbox": {
                "l": 216,
                "t": 725.76,
                "r": 390.72,
                "b": 693.84
            },
            "text": "Abuse Victim Addendum\nAdditional page (if necessary)",
            "attrs": {
                "block_label": "doc_title"
            },
            "level": 2
        },
        {
            "id": "p11.4",
            "order": 4,
            "type": "table",
            "bbox": {
                "l": 70.8,
                "t": 685.2,
                "r": 581.04,
                "b": 175.44
            },
            "text": "",
            "attrs": {
                "block_label": "table",
                "n_rows": 14,
                "n_cols": 3,
                "integrity": {
                    "cells_checked": 35,
                    "cells_flagged": 4,
                    "flags": [
                        {
                            "row": 4,
                            "col": 2,
                            "coverage": 0.2,
                            "text": "Alternative Reference:AV ___ Employer's Name & Address"
                        },
                        {
                            "row": 5,
                            "col": 2,
                            "coverage": 0.5,
                            "text": "Alternative Reference:AV ___ Work Schedule"
                        },
                        {
                            "row": 11,
                            "col": 2,
                            "coverage": 0.2,
                            "text": "Alternative Reference:AV ___ Employer's Name & Address"
                        },
                        {
                            "row": 12,
                            "col": 2,
                            "coverage": 0.5,
                            "text": "Alternative Reference:AV ___ Work Schedule"
                        }
                    ]
                }
            },
            "children": [
                {
                    "id": "p11.4.1",
                    "order": 5,
                    "type": "table_cell",
                    "bbox": {
                        "l": 239.258,
                        "t": 681.715,
                        "r": 375.526,
                        "b": 667.052
                    },
                    "text": "Type of Family Court Action",
                    "attrs": {
                        "row": 0,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 3,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p11.4.2",
                    "order": 6,
                    "type": "table_cell",
                    "bbox": {
                        "l": 142.7,
                        "t": 661.37436,
                        "r": 325.5532,
                        "b": 629.54864
                    },
                    "text": "Divorce, Annulment, Dissolution of Marriage Support",
                    "attrs": {
                        "row": 1,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.2.1",
                            "order": 7,
                            "type": "form_field",
                            "bbox": {
                                "l": 256.96,
                                "t": 645.551,
                                "r": 274.96,
                                "b": 627.551
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if paternity2",
                                "source": "acroform",
                                "row": 1,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Divorce, Annulment, Dissolution of Marriage Support",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.2",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.3",
                    "order": 8,
                    "type": "table_cell",
                    "bbox": {
                        "l": 279.41,
                        "t": 642.5743600000001,
                        "r": 315.55486,
                        "b": 631.54864
                    },
                    "text": "Paternity",
                    "attrs": {
                        "row": 1,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p11.4.4",
                    "order": 9,
                    "type": "table_cell",
                    "bbox": {
                        "l": 399.31,
                        "t": 661.37436,
                        "r": 490.148,
                        "b": 629.54864
                    },
                    "text": "Child Custody Protection from Abuse",
                    "attrs": {
                        "row": 1,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.4.1",
                            "order": 10,
                            "type": "form_field",
                            "bbox": {
                                "l": 377.422,
                                "t": 664.928,
                                "r": 395.422,
                                "b": 646.928
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if child custody2",
                                "source": "acroform",
                                "row": 1,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Child Custody Protection from Abuse",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.4",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        },
                        {
                            "id": "p11.4.4.2",
                            "order": 11,
                            "type": "form_field",
                            "bbox": {
                                "l": 377.422,
                                "t": 643.924,
                                "r": 395.422,
                                "b": 625.924
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if protection from abuse2",
                                "source": "acroform",
                                "row": 1,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Child Custody Protection from Abuse",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.4"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.5",
                    "order": 12,
                    "type": "table_cell",
                    "bbox": {
                        "l": 92.664,
                        "t": 622.07896,
                        "r": 216.617956,
                        "b": 608.80228
                    },
                    "text": "This Information Pertains to:",
                    "attrs": {
                        "row": 2,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.5.1",
                            "order": 13,
                            "type": "form_field",
                            "bbox": {
                                "l": 119.716,
                                "t": 665.301,
                                "r": 137.716,
                                "b": 647.301
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if divorce, annulment or dissolution of marriage2",
                                "source": "acroform",
                                "row": 2,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "This Information Pertains to:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.5",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        },
                        {
                            "id": "p11.4.5.2",
                            "order": 14,
                            "type": "form_field",
                            "bbox": {
                                "l": 119.716,
                                "t": 644.551,
                                "r": 138.089,
                                "b": 626.551
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if support2",
                                "source": "acroform",
                                "row": 2,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "This Information Pertains to:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.5"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.6",
                    "order": 15,
                    "type": "table_cell",
                    "bbox": {
                        "l": 258.65,
                        "t": 620.73436,
                        "r": 368.7272,
                        "b": 609.7086400000001
                    },
                    "text": "Confidential Information:",
                    "attrs": {
                        "row": 2,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.6.1",
                            "order": 16,
                            "type": "form_field",
                            "bbox": {
                                "l": 241.538,
                                "t": 588.56,
                                "r": 392.738,
                                "b": 572
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim2 address",
                                "source": "acroform",
                                "row": 2,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Confidential Information:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.6"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.7",
                    "order": 17,
                    "type": "table_cell",
                    "bbox": {
                        "l": 434.95,
                        "t": 620.73436,
                        "r": 522.25614,
                        "b": 609.7086400000001
                    },
                    "text": "References in Filing:",
                    "attrs": {
                        "row": 2,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p11.4.8",
                    "order": 18,
                    "type": "table_cell",
                    "bbox": {
                        "l": 70.8,
                        "t": 575.9657,
                        "r": 240.88,
                        "b": 539.5543
                    },
                    "text": "",
                    "attrs": {
                        "row": 3,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p11.4.9",
                    "order": 19,
                    "type": "table_cell",
                    "bbox": {
                        "l": 406.744,
                        "t": 596.33872,
                        "r": 468.72692,
                        "b": 583.25128
                    },
                    "text": "AV Address:",
                    "attrs": {
                        "row": 3,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.9.1",
                            "order": 20,
                            "type": "form_field",
                            "bbox": {
                                "l": 421.548,
                                "t": 599.46,
                                "r": 435.948,
                                "b": 582.9
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number2 address",
                                "source": "acroform",
                                "row": 3,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Address:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.9",
                                "text_offset": 2,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.10",
                    "order": 21,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 575.9657,
                        "r": 581.04,
                        "b": 539.5543
                    },
                    "text": "Alternative Reference:AV ___ Address",
                    "attrs": {
                        "row": 3,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p11.4.11",
                    "order": 22,
                    "type": "table_cell",
                    "bbox": {
                        "l": 98.944,
                        "t": 566.09436,
                        "r": 206.50296,
                        "b": 555.06864
                    },
                    "text": "(full name of abuse victim)",
                    "attrs": {
                        "row": 4,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.11.1",
                            "order": 23,
                            "type": "form_field",
                            "bbox": {
                                "l": 77.04,
                                "t": 586,
                                "r": 229.32,
                                "b": 569.44
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Full name of abuse victim2",
                                "source": "acroform",
                                "label": "(full name of abuse victim)",
                                "row": 4,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label_source": "parent_text",
                                "label_ref": "p11.4.11"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.12",
                    "order": 24,
                    "type": "table_cell",
                    "bbox": {
                        "l": 406.744,
                        "t": 547.73672,
                        "r": 554.18488,
                        "b": 534.64928
                    },
                    "text": "AV Employer's Name & Address:",
                    "attrs": {
                        "row": 4,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.12.1",
                            "order": 25,
                            "type": "form_field",
                            "bbox": {
                                "l": 421.294,
                                "t": 551.096,
                                "r": 435.694,
                                "b": 534.536
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number2 employer name and address",
                                "source": "acroform",
                                "row": 4,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Employer's Name & Address:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.12",
                                "text_offset": 2,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.13",
                    "order": 26,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 539.5543,
                        "r": 581.04,
                        "b": 503.1429
                    },
                    "text": "Alternative Reference:AV ___ Employer's Name & Address",
                    "attrs": {
                        "row": 4,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p11.4.14",
                    "order": 27,
                    "type": "table_cell",
                    "bbox": {
                        "l": 79.8001,
                        "t": 514.07572,
                        "r": 227.78578,
                        "b": 500.98828
                    },
                    "text": "Docket/Case No. of Protection Order",
                    "attrs": {
                        "row": 5,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.14.1",
                            "order": 28,
                            "type": "form_field",
                            "bbox": {
                                "l": 78.4045,
                                "t": 530.065,
                                "r": 228.404,
                                "b": 513.505
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Docket/Case No. of Protection Order2",
                                "source": "acroform",
                                "row": 5,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Docket/Case No. of Protection Order",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.14"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.15",
                    "order": 29,
                    "type": "table_cell",
                    "bbox": {
                        "l": 241.97,
                        "t": 511.98436,
                        "r": 322.85334,
                        "b": 500.95864
                    },
                    "text": "AV Work Schedule:",
                    "attrs": {
                        "row": 5,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.15.1",
                            "order": 30,
                            "type": "form_field",
                            "bbox": {
                                "l": 242.4,
                                "t": 540.8,
                                "r": 396.6,
                                "b": 524.24
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim2 employer name and address",
                                "source": "acroform",
                                "row": 5,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Work Schedule:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.15"
                            }
                        },
                        {
                            "id": "p11.4.15.2",
                            "order": 31,
                            "type": "form_field",
                            "bbox": {
                                "l": 242.4,
                                "t": 492.68,
                                "r": 396.6,
                                "b": 476.12
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim2 work schedule",
                                "source": "acroform",
                                "row": 5,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Work Schedule:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.15"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.16",
                    "order": 32,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 503.1429,
                        "r": 581.04,
                        "b": 466.7314
                    },
                    "text": "Alternative Reference:AV ___ Work Schedule",
                    "attrs": {
                        "row": 5,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    },
                    "children": [
                        {
                            "id": "p11.4.16.1",
                            "order": 33,
                            "type": "form_field",
                            "bbox": {
                                "l": 419.921,
                                "t": 504.85,
                                "r": 434.321,
                                "b": 488.29
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number2 work schedule",
                                "source": "acroform",
                                "row": 5,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Alternative Reference:AV ___ Work Schedule",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.16",
                                "text_offset": 25,
                                "text_span": 3
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.17",
                    "order": 34,
                    "type": "table_cell",
                    "bbox": {
                        "l": 125.3241,
                        "t": 464.38372,
                        "r": 180.11406,
                        "b": 451.29628
                    },
                    "text": "Court/County",
                    "attrs": {
                        "row": 6,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.17.1",
                            "order": 35,
                            "type": "form_field",
                            "bbox": {
                                "l": 79.5326,
                                "t": 479.992,
                                "r": 229.533,
                                "b": 463.432
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "County/Court2",
                                "source": "acroform",
                                "row": 6,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Court/County",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.17"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.18",
                    "order": 36,
                    "type": "table_cell",
                    "bbox": {
                        "l": 406.744,
                        "t": 454.96072,
                        "r": 539.569123,
                        "b": 441.87328
                    },
                    "text": "AV Other contact information:",
                    "attrs": {
                        "row": 6,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.18.1",
                            "order": 37,
                            "type": "form_field",
                            "bbox": {
                                "l": 421.294,
                                "t": 458.232,
                                "r": 435.694,
                                "b": 441.672
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number2 other contact information",
                                "source": "acroform",
                                "row": 6,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Other contact information:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.18",
                                "text_offset": 2,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.19",
                    "order": 38,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 466.7314,
                        "r": 581.04,
                        "b": 430.32
                    },
                    "text": "Alternative Reference:AV ___ Other contact information",
                    "attrs": {
                        "row": 6,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p11.4.20",
                    "order": 39,
                    "type": "table_cell",
                    "bbox": {
                        "l": 250.747,
                        "t": 420.713,
                        "r": 374.627,
                        "b": 407.383
                    },
                    "text": "Type of Family Court Action",
                    "attrs": {
                        "row": 7,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 3,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.20.1",
                            "order": 40,
                            "type": "form_field",
                            "bbox": {
                                "l": 241.296,
                                "t": 445.552,
                                "r": 397.636,
                                "b": 428.992
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim2 other contact information",
                                "source": "acroform",
                                "row": 7,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 3,
                                "label": "Type of Family Court Action",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.20"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.21",
                    "order": 41,
                    "type": "table_cell",
                    "bbox": {
                        "l": 156.26,
                        "t": 406.06436,
                        "r": 339.7128,
                        "b": 374.23864
                    },
                    "text": "Divorce, Annulment, Dissolution of Marriage Support",
                    "attrs": {
                        "row": 8,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.21.1",
                            "order": 42,
                            "type": "form_field",
                            "bbox": {
                                "l": 274.489,
                                "t": 389.456,
                                "r": 292.489,
                                "b": 371.456
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if paternity3",
                                "source": "acroform",
                                "row": 8,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Divorce, Annulment, Dissolution of Marriage Support",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.21",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.22",
                    "order": 43,
                    "type": "table_cell",
                    "bbox": {
                        "l": 401.59,
                        "t": 408.06436,
                        "r": 492.3179,
                        "b": 374.23864
                    },
                    "text": "Child Custody Protection from Abuse",
                    "attrs": {
                        "row": 8,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 2,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.22.1",
                            "order": 44,
                            "type": "form_field",
                            "bbox": {
                                "l": 380.778,
                                "t": 410.832,
                                "r": 398.778,
                                "b": 392.832
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if child custody3",
                                "source": "acroform",
                                "row": 8,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 2,
                                "label": "Child Custody Protection from Abuse",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.22",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        },
                        {
                            "id": "p11.4.22.2",
                            "order": 45,
                            "type": "form_field",
                            "bbox": {
                                "l": 380.778,
                                "t": 389.202,
                                "r": 398.778,
                                "b": 371.202
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if protection from abuse3",
                                "source": "acroform",
                                "row": 8,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 2,
                                "label": "Child Custody Protection from Abuse",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.22"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.23",
                    "order": 46,
                    "type": "table_cell",
                    "bbox": {
                        "l": 92.664,
                        "t": 367.86896,
                        "r": 216.617956,
                        "b": 354.59228
                    },
                    "text": "This Information Pertains to:",
                    "attrs": {
                        "row": 9,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.23.1",
                            "order": 47,
                            "type": "form_field",
                            "bbox": {
                                "l": 135.752,
                                "t": 410.459,
                                "r": 153.752,
                                "b": 392.459
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "Check if divorce, annulment or dissolution of marriage3",
                                "source": "acroform",
                                "row": 9,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "This Information Pertains to:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.23",
                                "text_offset": 0,
                                "text_span": 0
                            }
                        },
                        {
                            "id": "p11.4.23.2",
                            "order": 48,
                            "type": "form_field",
                            "bbox": {
                                "l": 135.752,
                                "t": 389.202,
                                "r": 153.752,
                                "b": 371.202
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "checkbox",
                                "pdf_field_name": "check if support3",
                                "source": "acroform",
                                "row": 9,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "This Information Pertains to:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.23",
                                "text_offset": 4,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.24",
                    "order": 49,
                    "type": "table_cell",
                    "bbox": {
                        "l": 258.65,
                        "t": 366.52436,
                        "r": 368.7272,
                        "b": 355.49864
                    },
                    "text": "Confidential Information:",
                    "attrs": {
                        "row": 9,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.24.1",
                            "order": 50,
                            "type": "form_field",
                            "bbox": {
                                "l": 241.92,
                                "t": 334.16,
                                "r": 393.12,
                                "b": 317.6
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim3 address",
                                "source": "acroform",
                                "row": 9,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Confidential Information:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.24"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.25",
                    "order": 51,
                    "type": "table_cell",
                    "bbox": {
                        "l": 434.95,
                        "t": 366.52436,
                        "r": 522.25614,
                        "b": 355.49864
                    },
                    "text": "References in Filing:",
                    "attrs": {
                        "row": 9,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p11.4.26",
                    "order": 52,
                    "type": "table_cell",
                    "bbox": {
                        "l": 70.8,
                        "t": 321.0857,
                        "r": 240.88,
                        "b": 284.6743
                    },
                    "text": "",
                    "attrs": {
                        "row": 10,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p11.4.27",
                    "order": 53,
                    "type": "table_cell",
                    "bbox": {
                        "l": 406.744,
                        "t": 341.93472,
                        "r": 468.72692,
                        "b": 328.84728
                    },
                    "text": "AV Address:",
                    "attrs": {
                        "row": 10,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.27.1",
                            "order": 54,
                            "type": "form_field",
                            "bbox": {
                                "l": 421.667,
                                "t": 344.856,
                                "r": 436.067,
                                "b": 328.296
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number3",
                                "source": "acroform",
                                "row": 10,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Address:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.27",
                                "text_offset": 2,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.28",
                    "order": 55,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 321.0857,
                        "r": 581.04,
                        "b": 284.6743
                    },
                    "text": "Alternative Reference:AV ___ Address",
                    "attrs": {
                        "row": 10,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p11.4.29",
                    "order": 56,
                    "type": "table_cell",
                    "bbox": {
                        "l": 96.944,
                        "t": 312.76436,
                        "r": 204.50296,
                        "b": 301.73864
                    },
                    "text": "(full name of abuse victim)",
                    "attrs": {
                        "row": 11,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.29.1",
                            "order": 57,
                            "type": "form_field",
                            "bbox": {
                                "l": 77.04,
                                "t": 331.6,
                                "r": 229.32,
                                "b": 315.04
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Full name of abuse victim3",
                                "source": "acroform",
                                "label": "(full name of abuse victim)",
                                "row": 11,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label_source": "parent_text",
                                "label_ref": "p11.4.29"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.30",
                    "order": 58,
                    "type": "table_cell",
                    "bbox": {
                        "l": 406.744,
                        "t": 293.33272,
                        "r": 554.274884,
                        "b": 280.24528
                    },
                    "text": "AV Employer's Name & Address:",
                    "attrs": {
                        "row": 11,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.30.1",
                            "order": 59,
                            "type": "form_field",
                            "bbox": {
                                "l": 421.548,
                                "t": 296.746,
                                "r": 435.948,
                                "b": 280.186
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number3 employer name and address",
                                "source": "acroform",
                                "row": 11,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Employer's Name & Address:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.30",
                                "text_offset": 2,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.31",
                    "order": 60,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 284.6743,
                        "r": 581.04,
                        "b": 248.2629
                    },
                    "text": "Alternative Reference:AV ___ Employer's Name & Address",
                    "attrs": {
                        "row": 11,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p11.4.32",
                    "order": 61,
                    "type": "table_cell",
                    "bbox": {
                        "l": 78.7761,
                        "t": 258.57272,
                        "r": 226.76178,
                        "b": 245.48528
                    },
                    "text": "Docket/Case No. of Protection Order",
                    "attrs": {
                        "row": 12,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.32.1",
                            "order": 62,
                            "type": "form_field",
                            "bbox": {
                                "l": 78.4045,
                                "t": 274.777,
                                "r": 228.404,
                                "b": 258.217
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Docket/Case No. of Protection Order3",
                                "source": "acroform",
                                "row": 12,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Docket/Case No. of Protection Order",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.32"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.33",
                    "order": 63,
                    "type": "table_cell",
                    "bbox": {
                        "l": 241.97,
                        "t": 257.68435999999997,
                        "r": 322.85334,
                        "b": 246.65864
                    },
                    "text": "AV Work Schedule:",
                    "attrs": {
                        "row": 12,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.33.1",
                            "order": 64,
                            "type": "form_field",
                            "bbox": {
                                "l": 242.4,
                                "t": 286.52,
                                "r": 396.6,
                                "b": 269.96
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim 3 employer name and address",
                                "source": "acroform",
                                "row": 12,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Work Schedule:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.33"
                            }
                        },
                        {
                            "id": "p11.4.33.2",
                            "order": 65,
                            "type": "form_field",
                            "bbox": {
                                "l": 242.4,
                                "t": 238.4,
                                "r": 396.6,
                                "b": 221.84
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim3 work schedule",
                                "source": "acroform",
                                "row": 12,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Work Schedule:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.33"
                            }
                        },
                        {
                            "id": "p11.4.33.3",
                            "order": 66,
                            "type": "form_field",
                            "bbox": {
                                "l": 242.042,
                                "t": 191.202,
                                "r": 397.636,
                                "b": 174.642
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Abuse victim 3 other contact information",
                                "source": "acroform",
                                "row": 12,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Work Schedule:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.33"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.34",
                    "order": 67,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 248.2629,
                        "r": 581.04,
                        "b": 211.8514
                    },
                    "text": "Alternative Reference:AV ___ Work Schedule",
                    "attrs": {
                        "row": 12,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    },
                    "children": [
                        {
                            "id": "p11.4.34.1",
                            "order": 68,
                            "type": "form_field",
                            "bbox": {
                                "l": 420.548,
                                "t": 250.128,
                                "r": 434.948,
                                "b": 233.568
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number 3 work schedule",
                                "source": "acroform",
                                "row": 12,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Alternative Reference:AV ___ Work Schedule",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.34",
                                "text_offset": 25,
                                "text_span": 3
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.35",
                    "order": 69,
                    "type": "table_cell",
                    "bbox": {
                        "l": 124.7481,
                        "t": 203.30172000000005,
                        "r": 179.53806,
                        "b": 190.21428000000003
                    },
                    "text": "Court/County",
                    "attrs": {
                        "row": 13,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.35.1",
                            "order": 70,
                            "type": "form_field",
                            "bbox": {
                                "l": 77.8404,
                                "t": 219.063,
                                "r": 227.84,
                                "b": 202.503
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "Court/County3",
                                "source": "acroform",
                                "row": 13,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "Court/County",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.35"
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.36",
                    "order": 71,
                    "type": "table_cell",
                    "bbox": {
                        "l": 406.744,
                        "t": 200.43772,
                        "r": 539.569123,
                        "b": 187.35028
                    },
                    "text": "AV Other contact information:",
                    "attrs": {
                        "row": 13,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p11.4.36.1",
                            "order": 72,
                            "type": "form_field",
                            "bbox": {
                                "l": 421.667,
                                "t": 203.628,
                                "r": 436.067,
                                "b": 187.068
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "pdf_field_name": "alternative reference number3 other contact information",
                                "source": "acroform",
                                "row": 13,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "AV Other contact information:",
                                "label_source": "parent_text",
                                "label_ref": "p11.4.36",
                                "text_offset": 2,
                                "text_span": 0
                            }
                        }
                    ]
                },
                {
                    "id": "p11.4.37",
                    "order": 73,
                    "type": "table_cell",
                    "bbox": {
                        "l": 410.96,
                        "t": 211.8514,
                        "r": 581.04,
                        "b": 175.44
                    },
                    "text": "Alternative Reference:AV ___ Other contact information",
                    "attrs": {
                        "row": 13,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
                    }
                }
            ]
        },
        {
            "id": "p11.5",
            "order": 74,
            "type": "footer",
            "bbox": {
                "l": 71.04,
                "t": 25.2,
                "r": 131.28,
                "b": 12.48
            },
            "text": "Rev. 7/2018",
            "attrs": {
                "block_label": "footer"
            }
        },
        {
            "id": "p11.6",
            "order": 75,
            "type": "footer",
            "bbox": {
                "l": 183.6,
                "t": 29.76,
                "r": 420,
                "b": 14.88
            },
            "text": "THIS FORM IS CONFIDENTIAL",
            "attrs": {
                "block_label": "footer"
            }
        }
    ],
    "excluded_furniture": {
        "first": [],
        "last": []
    }
}