Senator John Blake
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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
  • Grant Application
  • 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)
  • Application for Medicare Part B Payment
  • HIPAA Release Form
  • COMPASS Site
  • County Assistance Offices
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District Office

Oppenheim Building
409 Lackawanna Avenue • Suite 210
Scranton, PA 18503
(570) 207-2881
Fax: (570) 207-2897
Toll free: 1-877-346-5721

Harrisburg Office

Room 17 East Wing
The State Capitol
Senate Box 203022
Harrisburg, PA 17120-3022
(717) 787-6481
Fax: (717) 783-5198

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