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Pennsylvania Senate District 5
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  • 5TH DISTRICT
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Applications & Forms

General

  • Absentee & Mail-In Ballot Application
  • Birth & Death Certificate Application
  • Criminal Record Check Application
  • Child Abuse Clearance Application
  • Consumer Complaint Forms
  • Hunting License
  • Insurance Complaint Form
  • Fishing License
  • Notary Public Applications
  • Prescription Assistance Applications
  • Pennsylvania Department of Revenue
  • Public Utility Commission Complaint Form
  • Property Tax & Rent Rebate Forms
  • State Income Tax Forms
  • Voter Registration Application

Applications for State Employment

  • State Civil Service Commission Application
  • Bureau of State Employment Personal Data Sheet

Department of Human Services

  • Application for Benefits (Medical Assistance, Food Stamps, Cash Assistance)
  • Application for Medical Assistance for Workers with Disabilities (MAWD)
  • HIPAA Release Form
  • HIPAA Release Form (Spanish)
  • COMPASS Site
  • County Assistance Offices

Services

  • Services We Provide →
  • Applications & Forms →
  • Real ID →
  • Toll-Free Numbers →
  • Useful Links →
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District Office

8016 Bustleton Avenue
Philadelphia, PA 19152
Phone: (215) 695-1020
Fax: (215) 695-1027

District Office

12361 Academy Road
Philadelphia, PA 19154
Phone: (215) 281-2539
Fax: (215) 281-2798

Harrisburg Office

Senate Box 203005
Harrisburg, PA 17120-3005
Room: 543 Main Capitol
Phone: (717) 787-9608
Fax: (717) 772-2162

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