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2. Instructions

   Specific case information is needed to accurately complete this form. Refer to your hearing notice to complete the required fields. If you do not have your hearing notice, your case information can be found by searching under "Participant Name" at the Unified Judicial System of PA.

6. Defendant Information
8. Defendant's Name*
9. Date of Birth
   Date of Birth
11. Email*
12. Phone Number*
16. Case Information
18. Case Number*
19. Interpreter Needed?*

    1. Yes
    2. No
21. Assigned Judge*
    -- Select One --SnyderCookNessPrendergastKraft
25. Defendant Counsel Information
27. Counsel Name
28. Counsel Email
30. Counsel Phone Number
34. Hearing Information
36. Hearing Date*
    Hearing Date
37. Hearing Type
    -- Select One --ArraignmentBail HearingPre-Trial MotionIndirect Criminal Contempt (ICC)ForfeitureGuilty PleaSentencingSummary Conviction Appeal
41. Connection Method
43. Type of Device
    -- Select One --IPadIPhoneAndroid DevicePersonal Computer or Laptop
45. Additional Information
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field