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I understand that I may lose rights concerning alimony, division of property, lawyer's fees, costs and expenses, or other important rights if I do not claim them before a divorce is granted.", "marker": "(a)", "list_id": "L7", "level": 0, "reading_order": 21 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 69, "t": 151, "r": 87, "b": 133 }, "text": "Check if you wish to claim economic relief", "field_kind": "checkbox", "label": "Check if you wish to claim economic relief", "pdf_field_name": "Check Box2b", "pdf_field_type": "CheckBox", "reading_order": 22 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 105.12, "t": 150.24, "r": 516.48, "b": 119.04 }, "text": "(b) I wish to claim economic relief, which may include alimony, division of property, lawyer's fees, costs and expenses, or other important rights.", "marker": "(b)", "list_id": "L8", "level": 0, "reading_order": 23 }, { "page": 1, "type": "TEXT", "location": { "l": 68.4, "t": 105.6, "r": 541.44, "b": 74.88 }, "text": "I UNDERSTAND THAT IN ADDITION TO CHECKING (2)(b), I MUST ALSO FILE ALL OF MY ECONOMIC CLAIMS IN WRITING AND SERVE THEM ON THE OTHER", "reading_order": 24 } ] }, { "page": 2, "items": [ { "page": 2, "type": "TEXT", "location": { "l": 68.4, "t": 719.28, "r": 531.84, "b": 644.16 }, "text": "PARTY. IF I FAIL TO DO SO BEFORE THE DATE SET FORTH ON THE NOTICE OF\nINTENTION TO FILE THE PRAECIPE TO TRANSMIT RECORD, THE DIVORCE\nDECREE OR ORDER APPROVING GROUNDS FOR DIVORCE MAY BE ENTERED\nWITHOUT FURTHER NOTICE TO ME, AND I MAY BE UNABLE THEREAFTER TO\nFILE ANY ECONOMIC CLAIMS.", "reading_order": 0 }, { "page": 2, "type": "FORM_FIELD", "location": { "l": 70, "t": 630, "r": 88, "b": 612 }, "text": "Check if economic claims have been raised and are not resolved", "field_kind": "checkbox", "label": "Check if economic claims have been raised and are not resolved", "pdf_field_name": "Check Box2c", "pdf_field_type": "CheckBox", "reading_order": 1 }, { "page": 2, "type": "TEXT", "location": { "l": 105.12, "t": 629.04, "r": 446.88, "b": 613.68 }, "text": "(c) Economic claims have been raised and are not resolved.", "reading_order": 2 }, { "page": 2, "type": "TEXT", "location": { "l": 68.4, "t": 599.04, "r": 539.76, "b": 553.68 }, "text": "I verify that the statements made in this counter-affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. ยง 4904 relating to unsworn falsification to authorities.", "reading_order": 3 }, { "page": 2, "type": "TEXT", "location": { "l": 69.36, "t": 538.32, "r": 206.16, "b": 523.68 }, "text": "Date: _____", "reading_order": 4 }, { "page": 2, "type": "FORM_FIELD", "location": { "l": 104.04, "t": 546, "r": 204.24, "b": 524 }, "text": "Date - enter as mm/dd/yyyy ex. 09/27/2015", "field_kind": "text", "label": "Date - enter as mm/dd/yyyy ex. 09/27/2015", "pdf_field_name": "Date", "pdf_field_type": "Text", "reading_order": 5 }, { "page": 2, "type": "TITLE", "location": { "l": 256.08, "t": 524.4, "r": 412.8, "b": 509.28 }, "text": "(PLAINTIFF) (DEFENDANT)", "reading_order": 6, "level": 2 }, { "page": 2, "type": "TEXT", "location": { "l": 68.4, "t": 493.92, "r": 527.52, "b": 433.44 }, "text": "NOTICE: IF YOU DO NOT WISH TO OPPOSE THE ENTRY OF A DIVORCE DECREE OR ORDER APPROVING GROUNDS FOR DIVORCE AND YOU DO NOT WISH TO MAKE ANY CLAIM FOR ECONOMIC RELIEF, YOU SHOULD NOT FILE THIS COUNTER-AFFIDAVIT.", "reading_order": 7 } ] }, { "page": 3, "items": [ { "page": 3, "type": "TITLE", "location": { "l": 82.32, "t": 720.48, "r": 528.72, "b": 691.2 }, "text": "IN THE COURT OF COMMON PLEAS FOR ADAMS COUNTY, PENNSYLVANIA\nCIVIL ACTION - LAW", "reading_order": 0, "level": 1 }, { "page": 3, "type": "FORM_FIELD", "location": { "l": 72, "t": 692.64, "r": 269.986, "b": 666.12 }, "text": "Name1(CICForm)", "field_kind": "text", "label": "Name1(CICForm)", "pdf_field_name": "Name1(CICForm)", "pdf_field_type": "Text", "reading_order": 1 }, { "page": 3, "type": "TABLE", "location": { "l": 66.96, "t": 670.08, "r": 282.24, "b": 511.2 }, "text": "
NamePLAINTIFF
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and (if applicable)
NameDEFENDANT 2
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"cells": [ { "location": [ 66.96, 511.2, 174.6, 542.976 ], "text": "Name", "html_text": "Name", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": true, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 174.6, 511.2, 282.24, 542.976 ], "text": "DEFENDANT 2", "html_text": "DEFENDANT 2", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 5, "n_cols": 2, "ref": "#/tables/0", "reading_order": 2 }, { "page": 3, "type": "FORM_FIELD", "location": { "l": 72, "t": 623.64, "r": 269.986, "b": 597.12 }, "text": "Name2(CICForm)", "field_kind": "text", "label": "Name2(CICForm)", "pdf_field_name": "Name2(CICForm)", "pdf_field_type": "Text", "reading_order": 3 }, { "page": 3, "type": "FORM_FIELD", "location": { "l": 72, "t": 554.64, "r": 269.986, "b": 528.12 }, "text": "Name3(CICForm)", "field_kind": "text", "label": "Name3(CICForm)", "pdf_field_name": "Name3(CICForm)", "pdf_field_type": "Text", "reading_order": 4 }, { "page": 3, "type": "FORM_FIELD", "location": { "l": 383.04, "t": 651.24, "r": 490.92, "b": 624.72 }, "text": "Case(CICForm)", "field_kind": "text", "label": "Case(CICForm)", "pdf_field_name": "Case(CICForm)", "pdf_field_type": "Text", "reading_order": 5 }, { "page": 3, "type": "TEXT", "location": { "l": 321.84, "t": 637.2, "r": 492.96, "b": 621.6 }, "text": "CASE NO. _____", "reading_order": 6 }, { "page": 3, "type": "TITLE", "location": { "l": 208.8, "t": 471.36, "r": 402.48, "b": 457.2 }, "text": "CERTIFICATE OF COMPLIANCE", "reading_order": 7, "level": 2 }, { "page": 3, "type": "TEXT", "location": { "l": 68.64, "t": 443.52, "r": 532.8, "b": 387.12 }, "text": "I certify that this filing complies with the provisions of the Case Record Public Access Policy of the Unified Judicial System of Pennsylvania: Case Records of the Appellate and Trial Courts that require filing confidential information and documents differently than non-confidential information and documents.", "reading_order": 8 }, { "page": 3, "type": "TEXT", "location": { "l": 69.6, "t": 346.8, "r": 306.48, "b": 331.92 }, "text": "Signature: _____", "reading_order": 9 }, { "page": 3, "type": "TEXT", "location": { "l": 68.88, "t": 332.16, "r": 306, "b": 318.24 }, "text": "Petitioner\nDate: _____", "reading_order": 10 }, { "page": 3, "type": "TEXT", "location": { "l": 69.84, "t": 305.28, "r": 309.36, "b": 290.16 }, "text": "Print Name: _____", "reading_order": 11 }, { "page": 3, "type": "FORM_FIELD", "location": { "l": 133.32, "t": 320.16, "r": 307.32, "b": 293.64 }, "text": "Name4(CICForm)", "field_kind": "text", "label": "Name4(CICForm)", "pdf_field_name": "Name4(CICForm)", "pdf_field_type": "Text", "reading_order": 12 }, { "page": 3, "type": "TEXT", "location": { "l": 357.6, "t": 346.8, "r": 510.48, "b": 331.92 }, "text": "Date:", "reading_order": 13 }, { "page": 3, "type": 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