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State Senator Nick Miller
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Select Page

Applications & Forms

General

  • Absentee & Mail-In Ballot 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
  • Public Utility Commission Complaint Form
  • Property Tax & Rent Rebate Forms
  • State Income Tax Forms
  • Voter Registration Application

Birth & Death Certificates

  • Call the district at 610-929-2151 for processing options.
  • PA Department of Health Applications

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

How Can I Help?

  • → Applications & Forms
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  • → Toll-Free Phone Numbers
  • → Unclaimed Property

District Office

740 W Hamilton Street
Suite 200
Allentown, PA 18101
Phone: (610) 821-8468
Text: (610) 801-1701

Harrisburg Office

352 Main Capitol Building
Senate Box 203014
Harrisburg, PA 17120-3014
Phone: (717) 787-7105
Text: (610) 801-1701

Hanover Township Community Center

3660 Jacksonville Road
Bethlehem, PA 18017
Second Wednesday of every month
9 am – 11:30 am

Catasauqua Municipal Building

90 Bridge Street
Catasauqua, PA 18032
Second Wednesday of each month
1 pm-3 pm

Northampton Recreation Center

1 Lerchenmiller Drive
Northampton, PA 18067
Third Tuesday of every month
9:00 am – 11:30 am

Bath Borough Hall

121 S Walnut Street
Bath, PA 18014
Third Tuesday of every month
1 pm – 3 pm

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