Senator Daylin Leach
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Applications & Forms

Forms

General

  • Absentee Ballot Application
  • Birth Certificate Application
  • Death Certificate Application
  • Criminal Record Check Application
  • Child Abuse Clearance Application
  • Consumer Complaint Forms
  • Grant Application
  • Hunting License
  • Fishing License
  • Notary Public Applications
  • Prescription Assistance Applications
  • Pennsylvania Department of Revenue
  • Pennsylvania Higher Education Assistance Agency (PHEAA)
  • PUC Complaint Form
  • Property Tax & Rent Rebate Forms
  • State Income Tax Forms
  • Voter Registration Application
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Applications for State Employment

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

  • Application for Benefits (Medical Assistance, Food Stamps, Cash Assistance)
  • Application for Medical Assistance for Workers with Disabilities (MAWD)
  • Application for Medicare Part B Payment
  • HIPAA Release Form
  • COMPASS Site
  • County Assistance Offices
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Last updated: March 27, 2013 at 9:14 am
 
  • Constituent Services

    • Applications & Forms
    • Constituent Services
    • Tours of the Capitol
    • Internships
    • Student Aid
    • Senate Citations
    • Unsung Heroes
    • Toll Free Numbers

DISTRICT OFFICE

601 S. Henderson Road
Suite 208
King of Prussia, PA 19406
Phone: (610) 768-4200
Fax: (610) 768-4204

HARRISBURG OFFICE

184 Main Capitol
Box 203017
Harrisburg, PA 17120
Phone: (717) 787-5544
Fax: (717) 705-7741

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