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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": "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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                        "b": 221.45863999999995
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                    "text": "Social Security Number (SSN):",
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                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
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                    "type": "table_cell",
                    "bbox": {
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                        "b": 189.3382
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                    "text": "Alternative Reference:SSN 2",
                    "attrs": {
                        "row": 6,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
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                },
                {
                    "id": "p6.12.19",
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                    "bbox": {
                        "l": 75.12,
                        "t": 189.3382,
                        "r": 231.68,
                        "b": 120.3491
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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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                        "col": 0,
                        "rowspan": 2,
                        "colspan": 1
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                    "children": [
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                            "type": "form_field",
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                            "text": "",
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                                "field_kind": "text",
                                "label": "second minor with the initials of",
                                "pdf_field_name": "Minors' Initials2",
                                "source": "acroform",
                                "row": 7,
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                                "label": "full name of additional minor",
                                "pdf_field_name": "full name of minor2",
                                "source": "acroform",
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                    "bbox": {
                        "l": 237.77,
                        "t": 197.92435999999998,
                        "r": 378.429853,
                        "b": 186.89864
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                    "text": "Financial Account Number (FAN):",
                    "attrs": {
                        "row": 7,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
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                            "type": "form_field",
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                                "l": 237.72,
                                "t": 214.36,
                                "r": 382.56,
                                "b": 197.8
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Social Security Number of second person",
                                "pdf_field_name": "Social Security Number2",
                                "source": "acroform",
                                "row": 7,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1
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                    ]
                },
                {
                    "id": "p6.12.21",
                    "order": 51,
                    "type": "table_cell",
                    "bbox": {
                        "l": 388.24,
                        "t": 189.3382,
                        "r": 544.8,
                        "b": 154.8436
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                    "text": "Alternative Reference:FAN 2",
                    "attrs": {
                        "row": 7,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1
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                },
                {
                    "id": "p6.12.22",
                    "order": 52,
                    "type": "table_cell",
                    "bbox": {
                        "l": 237.77,
                        "t": 163.45435999999995,
                        "r": 364.941958,
                        "b": 152.42863999999997
                    },
                    "text": "Driver License Number (DLN):",
                    "attrs": {
                        "row": 8,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
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                            "id": "p6.12.22.1",
                            "order": 53,
                            "type": "form_field",
                            "bbox": {
                                "l": 237.72,
                                "t": 179.92,
                                "r": 382.56,
                                "b": 163.36
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Financial Account Number of second person",
                                "pdf_field_name": "Financial Account Number2",
                                "source": "acroform",
                                "row": 8,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1
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                        }
                    ]
                },
                {
                    "id": "p6.12.23",
                    "order": 54,
                    "type": "table_cell",
                    "bbox": {
                        "l": 388.24,
                        "t": 154.8436,
                        "r": 544.8,
                        "b": 120.3491
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                    "text": "Alternative Reference:DLN 2",
                    "attrs": {
                        "row": 8,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1
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                },
                {
                    "id": "p6.12.24",
                    "order": 55,
                    "type": "table_cell",
                    "bbox": {
                        "l": 75.12,
                        "t": 120.3491,
                        "r": 231.68,
                        "b": 51.36
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                    "text": "(full name of minor)and date of birth: ___",
                    "attrs": {
                        "row": 9,
                        "col": 0,
                        "rowspan": 2,
                        "colspan": 1
                    },
                    "children": [
                        {
                            "id": "p6.12.24.1",
                            "order": 56,
                            "type": "form_field",
                            "bbox": {
                                "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",
                                "source": "acroform",
                                "row": 9,
                                "col": 0,
                                "rowspan": 2,
                                "colspan": 1,
                                "text_offset": 39,
                                "text_span": 3
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                        }
                    ]
                },
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                    "id": "p6.12.25",
                    "order": 57,
                    "type": "table_cell",
                    "bbox": {
                        "l": 237.77,
                        "t": 128.89436,
                        "r": 308.151842,
                        "b": 117.86864000000003
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                    "text": "State of Issuance:",
                    "attrs": {
                        "row": 9,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
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                            "order": 58,
                            "type": "form_field",
                            "bbox": {
                                "l": 237.72,
                                "t": 145.36,
                                "r": 382.56,
                                "b": 128.8
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "Drivers License Number of second person",
                                "pdf_field_name": "Drivers License Number2",
                                "source": "acroform",
                                "row": 9,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1
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                        },
                        {
                            "id": "p6.12.25.2",
                            "order": 59,
                            "type": "form_field",
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                                "l": 237.72,
                                "t": 110.92,
                                "r": 382.56,
                                "b": 94.36
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "label": "State of Issuance:",
                                "pdf_field_name": "State of Issuance2",
                                "source": "acroform",
                                "row": 9,
                                "col": 1,
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                {
                    "id": "p6.12.26",
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                    "type": "table_cell",
                    "bbox": {
                        "l": 388.24,
                        "t": 120.3491,
                        "r": 544.8,
                        "b": 51.36
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                    "text": "Alternative Reference:SID 2",
                    "attrs": {
                        "row": 9,
                        "col": 2,
                        "rowspan": 2,
                        "colspan": 1
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                },
                {
                    "id": "p6.12.27",
                    "order": 61,
                    "type": "table_cell",
                    "bbox": {
                        "l": 237.77,
                        "t": 94.45835999999997,
                        "r": 377.285786,
                        "b": 83.43263999999999
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                    "text": "State Identification Number (SID):",
                    "attrs": {
                        "row": 10,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
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                                "r": 382.68,
                                "b": 59.8
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                            "text": "",
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                                "field_kind": "text",
                                "label": "State Identification Number of second person",
                                "pdf_field_name": "State Identification Number2",
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                                "row": 10,
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                                "colspan": 1
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                        }
                    ]
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        {
            "id": "p6.13",
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            "type": "footer",
            "bbox": {
                "l": 70.56,
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                "r": 131.52,
                "b": 26.4
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            "text": "Rev. 7/2018",
            "attrs": {
                "block_label": "footer"
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        },
        {
            "id": "p6.14",
            "order": 64,
            "type": "footer",
            "bbox": {
                "l": 182.64,
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                "r": 421.2,
                "b": 27.12
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            "text": "THIS FORM IS CONFIDENTIAL",
            "attrs": {
                "block_label": "footer"
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        }
    ],
    "excluded_furniture": {
        "first": [],
        "last": []
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}