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the municipal secretary desktop reference manual - Southwestern ...

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FORM TITLE: Name and Address Change Form for Municipal Secretaries<br />

OFFICIAL NUMBER: None<br />

DUE DATE: Immediately upon appointment to position<br />

WHERE TO SEND COMPLETED FORM:<br />

Bureau of Municipal Services<br />

PennDOT<br />

400 North Street-8th Floor<br />

Harrisburg PA 17120<br />

NUMBER OF COPIES REQUIRED: ONE<br />

FOR ASSISTANCE: Municipal services representative in your district PennDOT office.<br />

FAILURE TO SUBMIT FORM RESULTS IN: Untimely receipt or failure to receive<br />

communications and/or revenues from PennDOT.<br />

PRIOR TO COMPLETING, ASSEMBLE THE FOLLOWING INFORMATION: None needed.<br />

HELPFUL HINTS:<br />

Make several extra copies of this form for ease in notifying o<strong>the</strong>r entities of your new<br />

appointment to <strong>the</strong> position.<br />

Mail as material is received that is incorrectly addressed.<br />

Municipal Services Employees are available year-round to assist with any forms<br />

questions.<br />

V-13<br />

Revised May 2006

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