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ALERT! In observance of the holiday: County of Berks offices and buildings will close to the public from 12 PM, December 24, 2024, through December 25, 2024 (reopening 8 AM, December 26, 2024) and 12 PM, December 31, 2024, through January 1, 2025 (reopening 8 AM, January 2, 2025).

Please note – 24/7 operations at the county courthouse and services center will remain operational.

Form Info

Form Info

How to Fill in the Form before Printing?


  1. If the text on the form looks small, you can ZOOM IN by clicking the ZOOM button on the Adobe Acrobat tool bar: Then hold the mouse pointer over the document and click until you can see it better. Then click the HAND button to continue filling in the blanks.
  2. Once you have completed filling in the form blanks, click the Printer icon on your browser's tool bar, or click File/Print from your browser's menu bar.
  3. When your form has printed, click your browser's Back button to return to this page.