[51 Pa.B. 4433]
[Saturday, August 7, 2021]
[Continued from previous Web Page]
Department of
LABOR & INDUSTRY
(L&I)
I. POLICY STATEMENTS
A. Labor & Industry Secretary
• Availability of First Aid, CPR, and Other Emergency Treatments
• Pennsylvania Worker and Community Right to Know Act Employee Workplace Notice
• Security Policy Statement
• Weapons Policy Statement
• Workforce Innovation and Equal Opportunity Act Policy Statement
• Workplace Violence Policy StatementB. Office of Equal Opportunity
Contact: James Kayer (717-787-1182)• Equal Employment Opportunity Policy Statement
• Contract Compliance Policy Statement
• Equal Opportunity Plan
• Disability-Related Employment Policy Statement
• Sexual Harassment Policy Statement
• Workforce Innovation and Opportunity Act Equal Opportunity Policy Statement
• Non-Discrimination Plan
• Designation of Equal Opportunity Officers
• Designation of Equal Opportunity Liaisons
• Limited English Proficiency Policy Statement
• Office of Equal Opportunity Civil Rights StatementC. Bureau of Workers' Compensation
• Health Care Under the Workers' Compensation Act BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Uninsured Employers Guaranty Fund BWC Website: www.dli.pa.gov (''Workers' Compensation'') (Contact Callie Dow, 717-941-9595)
• General Provisions of Act 57 of 1996 BWC Website: www.dli.pa.gov (''Workers' Compensation'')II. GUIDANCE MANUALS
A. Office of Vocational Rehabilitation (OVR)
Contact: Rod Alcidonis, Director, BBVS (ralcidonis@pa.gov); Stephanie Perry, Director, BVRS (stperry@pa.gov)OVR Numbered Memoranda:
• 04-300.02 Rehabilitation Teaching and Orientation & Mobility Performance Standards
• 09-200.01 Ticket to Work Program
• 10-100.02 Driver Services for OVR Employees
• 10-100.03 OVR Case Sharing
• 10-100.04 OVR Case Filing System
• 10-100.05 Provision of Services to OVR Employees, Relatives of OVR Employees, Individuals With Whom the Employee Has a Close Personal Relationship or other Cases Designated as Confidential Per Customer Request
• 10-200.01 Psychological Services—Qualifications, Approval, and Use of Psychological Providers and Services
• 10-300.01 Independent Living/Specialized Services Program Handbook
• 11-100.02 Competitive Bids—Procedures and Documentation
• 11-100.04 Alternate Format Policy
• 12-100.04 Clerical Procedures: OVR Base and Detailed Record, Program Referral, Intake, and Case Assignment Procedure
• 12.200.02 College and Other Post-Secondary Training
• 12-200.07 CWDS User Management Manual
• 12-200.08 Performance Factors and Standards—Clerk Typist 2, Clerk Typist 3, and Fiscal Assistants
• 12-300.01 Referring, Training and Placing VR Customers in the Business Enterprise Program
• 13-200.02 Voter Registration
• 13-200.03 Work and Home Site Modifications
• 18-200.01 Vehicle Modifications # 1—Guidelines
• 13-200.05 F.A.R.M. (Farming and Agriculture Rehabilitation Management) Service Provision Manual for Pennsylvania Farmers
• 21-200.01 School to Work Transition
• 14-100.03 OVR Records Retention and Disposition Procedures
• 20-200.04 Financial Needs Test
• 15-100.01 Appeals, Legal Requests, and Release of Information
• 15-200.01 Audiological Services, Interpreting Services, & Assistive Technology Procedures for Customers who are Deaf, Hard of Hearing, Late Deafened and Deaf-Blind
• 20-100.01 OVR Fiscal Procedures and Documentation
• 16-100.02 Provider Agreement Policy and Procedures
• 16-200.01 College & Other Post-Secondary Training
• 16-200.04 Small Business Ownership as a Vocational Goal for OVR Customers
• 20-200.02 On-The-Job Training
• 16-200.06 OVR Supported Employment Policy
• 17-200.01 Low Vision Services
• 20-200.03 Essential Procedures for the Vocational Rehabilitation Program
• 17-200.03 Psychological Services—Guidelines: Psycho-diagnostic and Vocational Assessment
• 97-200.08 Revised Guidelines—Specific Learning Disabilities
• 10-100.07 (02) Vehicle Modifications # 4
• 10-100.07 (04) Vehicle Modifications # 6
• 10-100.07 (05) Vehicle Modifications # 7Guidance Documents:
• 16-400.02 Apprenticeship Career Training OJT Initiative
• 17-400.03 CIE Assessment
• 17-400.04 Identity Verification Requirements for OVR Customers
• 17-400.06 Graduate Level Studies
• 18-400.01 OVR Attendance at IEP Meetings for Cyber School Students
• 20-400.01 Procedure for Service Customers on the OOS Waiting List
• 20-400.02 Procedure for Verifying Supported Employment Provider Staff Credentials
• 20-400.08 Period of Performance Guidance Manual
• 20-400.10 Job Retention Exemption
• 20-400.11 OVR Fiscal Review Process
• 20-400.12 CWDS Information for Job Retention Exemption
• 20-400.13 Identity Verification Requirements for OVR Customers
• 20-400.14 Overview of Telework Actions
• 20-400.15 Prior Approval Process
• 20-400.16 Staff Guidance for Setting up CART and Interpreter Services for Potentially Eligible Students
• 21-400.04 Marketing and Website Content Approval
• 21-400.05 Paperless Standard Operating ProceduresB. Bureau of Workers' Compensation
• Calculating 21-Day Compliance BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Return-to-Work Model BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• PA Workers' Compensation Employer Information Pamphlet, LIBC-200 (Workers' Compensation Guidelines for Employers.) BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Employers' Guide to Self-Insuring Workers' Compensation, LIBC-300 BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Workers' Compensation and the Injured Worker Pamphlet, LIBC-100 (Workers' Compensation Guidelines for Injured Workers.) BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Workers' Compensation and the Injured Worker Pamphlet-Spanish Edition, LIBC-100-(ESP) (Workers' Compensation Guidelines for Spanish-speaking Injured Workers.) BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Procedures for Completing an Application for Fee Review, BWC website: www.dli.pa.gov (''Workers' Compensation'')
• 2021 Statewide Average Weekly Wage Schedule. Revised effective January 1, 2021. BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Statement of Purpose of Adoption of Usual and Customary Charge. Effective November 1, 2010. BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Attention WC Providers and Insurers: Read the Bureau's response to questions regarding ICD-10 www.dli.pa.gov (''Workers' Compensation'')
• Changes to the WC Act as made by ACT 184 (HB1846): View the Amendments www.dli.pa.gov (''Workers' Compensation'')
• Bureau Code Listings. Updated Monthly. BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Safety Committee Box Score. Updated Monthly. BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Accident and Illness Prevention Service Provider Qualifications Guide. Contact: Michelle Muncie, Health and Safety Division, BWC (717-772-1636)
• HandS System BWC website: www.dli.pa.gov (''Workers' Compensation''). Contact: Eric Hoffman, Health and Safety Division, BWC (717-772-1635)
• State-Certified Workplace Safety Committee Brochure (LIBC-733) BWC website: www.dli.pa.gov (''Workers' Compensation'')
• PATHS: Pennsylvania Training for Health and Safety. BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Workplace Safety Committee Technical Assistance/Certification Assistance Manual (LIBC-55) BWC website: www.dli.pa.gov (''Workers' Compensation''). Contact: Eric Hoffman, Health and Safety Division, BWC (717-772-1635)
• Worker & Community Chemical Right to Know. BWC website: www.dli.pa.gov (''Workers' Compensation''). Contact: Eric Hoffman, Health and Safety Division, BWC (717-772-1635)
• Workers' Compensation Automation and Integration System (WCAIS) BWC website: www.dli.pa.gov (''Workers' Compensation'')
• WCAIS, Forms BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Claims Implementation Guide BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI PA R3 Event table BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI R3 Data Element table BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI R3 Edit Matrix BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Quick Reference Guide BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Error Code Description BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Relaxed Rules BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Claim Status Reference Sheet BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI FROI and SROI 02 Mapping Reference Sheet BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI FEIN Guide BWC website: www.dli.pa.gov (''Workers' Compensation'') EDI Quick Reference Guide for Attorneys (LIBC-145) BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Forms Solution Form to Transaction Guide (LIBC-146) BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Claims Scenarios for PA BWC website: www.dli.pa.gov (''Workers' Compensation'')
• FEIN Guide BWC website: www.dli.pa.gov (''Workers' Compensation'')
• LIBC Form to Transaction BWC website: www.dli.pa.gov (''Workers' Compensation'')
• The Common Flow of a Claim Guide BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Strategy Migration BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Forms Solution Cutover Strategy BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Crossover Documents BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Forms Solution DN Mapping BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Direct Filer Trading Partner Criteria BWC website: www.dli.pa.gov (''Workers' Compensation'')
• EDI Test and Production BWC website: www.dli.pa.gov (''Workers' Compensation'')
• WCAIS, Training Resources BWC website: www.dli.pa.gov (''Workers' Compensation'')
• WCAIS, Frequently Asked Questions BWC website: www.dli.pa.gov (''Workers' Compensation'')
• Workers' Compensation Fee Schedules BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• 2019 Medical Access Study Executive overview. BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Workers' Compensation and Workplace Safety Annual Report BWC Website. This information can be found on our website by clicking on the following link: Home (pa.gov)
• Frequently Asked Questions Workers' Compensation BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Frequently Asked Questions Health Care Services Review BWC Website: www.dli.pa.gov (''Workers' Compensation'')
• Frequently Asked Questions Workplace Safety Committee Certification Program BWC Website: www.dli.pa.gov (''Workers' Compensation'')C. Workers' Compensation Office of Adjudication
• Accommodation Requests: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Adjudication Process—Accommodation Requests
• Act 109 Child Support Lien Search: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Act 109 Employee Dependent Statement Form: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Adjudication Forms: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Adjudication Forms—WCOA Forms
• Alternate Dispute Resolution Contact Information: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Alternate Dispute Resolution—ADR Contact Information
• Alternate Dispute Resolution Information: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Alternate Dispute Resolution
• Alternate Dispute Resolution Pamphlet: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Alternate Dispute Resolution—Alternate Dispute Resolution Pamphlet
• Directions to Hearing Locations: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Directions to Hearing Locations
• Frequently Asked Questions: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Adjudication Process—Frequently Asked Questions
• Individual Judges' Procedures Including Special COVID Procedures: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Judge Information OR Individual WCOA Judges' Questionnaire
• Lawyer Referral Service: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication• Medical Fee Review Hearing Information: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Request for Hearing to Contest Fee
• Medicare Policy Evaluation and Approval of WC Lump Sum Settlements: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Adjudication Process—Medicare & WC Benefits
• Obtaining WC Hearing Transcripts: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Adjudication Process—Obtaining WC Hearing Transcripts
• Obtaining Unemployment Compensation Benefit Offset Information: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Other PA WC Regulations: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Requesting Records and Decisions: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Special rules of administrative practice and procedure before the Workers' Compensation Appeal Board: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Special rules of administrative practice and procedure before Workers' Compensation Judges: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• WC Act Changes as made by Act 147: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• WC Related Websites: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• WCAIS Claim Conversion Policy: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• WCAIS Training Guides: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—WCAIS Tips & Training
• WCOA E-mail Resource Accounts: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• WCOA Judge Manager, Director, and Chief Counsel Contact Information: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication—Adjudication Process—WCOA Contact Information
• WCOA Office Cancellation/Delay Policies: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Workers' Compensation Act: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Workers' Compensation Annual Report and other Publications: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation Adjudication
• Workers' Compensation Rate Schedules: http://www.dli.pa.gov—Individuals—Workers' Compensation Services—Workers' Compensation AdjudicationIII. OTHER
A. Center for Workforce Information and Analysis
Contact: Ed Legge (717-787-8646)
• New Hire Program forms for businesses to use to report new hires can be found at www.pacareerlink.pa.gov
• High Priority Occupations methodology and petition information is available at www.workstats.dli.pa.gov
• Federal contractors' affirmative action planning workforce demographics are available at www.workstats.dli.pa.govB. Bureau of Workforce Development Administration & Bureau of Workforce Partnership and Operations
Contact: Brenda Duppstadt (717-783-8042), Steve Wolf (717-787-6874)
• Workforce System Policy (WSP) No. 183-01 (C1), April 15, 2019, Oversight and Monitoring (Change 1)
• Workforce System Policy (WSP) No. 121-06 (C2), March 10, 2020, Local Workforce Delivery System—Common Identifier Policy (Change 2)
• Workforce System Policy (WSP) No. 121-05, June 7, 2017, Local Workforce Delivery System—PA CareerLink® Certification and Continuous Improvement
• PA CareerLink® System Operator, Feb. 9, 2021
• Workforce System Policy (WSP) No. 121-03, June 2017, Memorandum of Understanding (MOU) for the One-Stop Delivery System
• Workforce Innovation and Opportunity Act 2021-2024 Regional and Local Plans, Feb. 9, 2021
• Workforce Innovation and Opportunity Act Performance Reporting, Aug. 26, 2021
• Workforce System Policy (WSP) No. 184-02 (C1), Feb. 13, 2019, Sanctions—Initial Implementation of the Workforce Innovation and Opportunity Act (Change 1)
• Workforce System Policy (WSP) No. 01-2015 (C1), July 20, 2018, Pennsylvania's Workforce System of Record (Change 1)
• Workforce System Policy (WSP) No. 02-2015, Dec. 18, 2015, Local Governance Policy
• Workforce System Policy (WSP) No. 03-2015, Dec. 22, 2015, Financial Management Policy
• Workforce System Guidance (WSG) No. 03-2015, Dec. 23, 2015, Youth Eligibility Definitions—Initial Implementation of the Workforce Innovation and Opportunity Act
• Workforce System Guidance (WSG) No. 04-2015 (C1), Sept. 11, 2017, Self-Certification and Telephone/Document Inspection Verification—Initial Implementation of the Workforce Innovation and Opportunity Act (Change 1)
• Workforce System Policy (WSP) No. 04-2015 (C1), April 4, 2018, Eligible Training Providers—Initial Implementation of the Workforce Innovation and Opportunity Act (Change 1) • Workforce System Policy (WSP) No. 05-2015, Dec. 23, 2015, Priority of Service—Initial Implementation of the Workforce Innovation and Opportunity Act
• Workforce System Guidance (WSG) No. 06-2015, April 1, 2016, Incumbent Worker Training Activities—Initial Implementation of the Workforce Innovation and Opportunity Act
• Workforce System Policy (WSP) No. 06-2015 (C1). Aug. 27, 2018, Training Benchmarks and Definitions for Allowable Training Activities (Change 1)
• Workforce System Guidance (WSG) No. 02-2104, June 30, 2015, Process and Timeline for Designation of Pennsylvania's Local Workforce Development Areas—Initial Implementation of the Workforce Innovation and Opportunity Act of 2014
• Workforce Investment Information Notice (WIIN) No. 01-2005 (C2), April 26, 2007, WIA Title I Training through Individual Training Accounts (ITAs) in High Priority Occupants (HPOs) (Under Revision)
• Workforce Investment Information Notice (WIIN) No. 03-2005, June 20, 2006, Guidelines for the Competitive Procurement of Youth Services
• Workforce Investment Information Notice (WIIN) No. 12-2003 (C1), Jan. 31, 2008, Rapid Response Early Intervention and Trade Benefits Rights Interview Process (Under Revision)
• Workforce Investment Information Notice (WIIN) No. 09-2002, Oct. 03, 2002, WIA Performance Measures
• Workforce Investment Information Notice (WIIN) No. 12-2002. April 10, 2003, Questions and Answers Regarding the WIA Certification Process for Eligible Training Programs/Providers and Individual Training Accounts (ITAs) (Under Revision)
• Workforce Investment Information Notice (WIIN) No. 01-2001, July 1, 2001, Team PA CareerLink® Registration Policy
• Workforce Investment Information Notice (WIIN) No. 02-2001 (C1), July 21, 2003, Team PA CareerLink® Employment Services Registration Policy WIIN 2-01 (Change 1)
• Workforce Investment Information Notice (WIIN) No. 03-1999 (C2), Aug. 5, 2002, The Bureau of Workforce Investment is distributing the attached guidance information relevant to Title I WIA Eligibility Criteria for Registration and WIA Acceptable Eligibility Verification (Change 2)
• Workforce Investment Information Notice (WIIN) No. 04-1999 (C1), Aug. 6, 2002, Core, Intensive, Training, Optional, and Youth Services by Program Charts (Change 1)
• TANF Youth Development Program Manual, April 13, 2021C. Minimum Wage Advisory Board
• Annual Analysis of the Pennsylvania Minimum Wage—2007 through present is available at www.workstats.dli.pa.gov
D. Office of Vocational Rehabilitation (OVR)
• Order of Selection (OOS) Brochure—Connie Moonen (717-787-6176)
• The OVR Annual Report—Connie Moonen (717-787-6176)
• WIOA Combined State Plan Update—Lee Ann Stewart (717-787-3216)
• Employment Services for Persons with Disabilities—Connie Moonen (717-787-6176)
• The OVR Rehabilitation Services Handbook—Connie Moonen (717-787-6176)
• OVR Transition Guide for Professionals—Connie Moonen (717-787-6176)
• OVR—Transition From Substance Abuse to Recovery and Work (A Guide for Vocational Rehabilitation)—Connie Moonen (717-787-6176)
• Your Road to Independence—Connie Moonen (717-787-6176)
• Business Services—Doug Rand (717-772-1657)
• On-the-Job Training—Doug Rand (717-772-1657)
• Jobs for All, Youth Employment Initiative—Doug Rand (717-772-1657)E. State Workers' Insurance Fund
• Injury Hotline Reporting Sticker
• Employee Information for reporting of Work Related Injuries
• Workers' Compensation Employee Notice
• SWIF District Office Map and Directory
• Notice of Employer W/C coverage with SWIF (English & Spanish)
• SWIF Information Pamphlet
• ''You as a Witness'' in a Workers' Compensation Proceeding
• Benefits of Early Reporting of Injuries
• State Workers' Insurance Fund ''Checklist''
• SWIF's Early Return to Work Program
• Telephonic Reporting Questionnaire
• ''21 day rule'' Reporting guideline Letter
• SWIF Safety Policy and Program Outline
• Certified Safety Committee Addendum
• SWIF debit card brochure, SWIF direct deposit form (SWIF-180 REV 11-11), SWIF payment selection form
• Notice of subrogation lien against a third-party recovery under Section 319 of the Workers' Compensation Act
• Preferred Provider Organization (PPO) Notice
• Free Access to Statewide Preferred Provider Organization (PPO) Notice
• Return-to-Work Program Notice (It is not the same as the SWIF Early Return to Work Program previously listed. Both are still in use.)
• Memo Concerning Section 305.2 of the Workers' Compensation Act.
• Notice to SWIF Policyholders Concerning their Obligation to Comply with Bureau Regulation 121.3b
• Memo regarding access to Pennsylvania Training for Health and Safety (PATHS)
• PA Workplace Safety Committee Certification Program Online Filing Instructions
• SWIF Debit Card Brochure
• SWIF Direct Deposit Form—SWIF—180 REV 11-11
• SWIF Payment Selection Form
• CFPB Disclosure—SWIF—331
• CFPB Disclosure—SWIF—332
• 756-Cover Letter
• Acknowledgement to Employee
• Acknowledgement to Employer
• Delayed Reporting Notice
• Benefits Affidavit
• Acknowledgement to Employee—Claim Petition
• Acknowledgement to Employer—Claim Petition
• Inquiry Letter to Claimant re: Interest in C&R
• Overpayment Due/RTW Letter to Claimant
• Claim Status to Claimant
• Partial C&R
• Employee Consent Form
• Injured Worker's Statement
• Inquiry Letter to Attorney re: Claimant's Interest in C&R
• Claim Status Report Letter to Claimant Attorney
• 760-To Claimant Attorney for Claimant Signature Form
• Letter with LIBC760 Returned for Proper Completion
• Full C&R
• Acknowledgement to Estate of—Fatal
• Confirming C&R Letter to Claimant Attorney
• Denial Rescinded Letter
• Witness Statement
• Claimant Statement & Medical Release/Sign & Return
• Final Receipt-Cover Letter to Claimant
• Final Receipt Cover Letter to Employer
• LOE to Claimant
• Employers Affidavit
• AOR—LIBC—497
• Canceled IME
• Claimant Profile Sheet By Adjuster
• Confirmation—IME
• IME Claimant Letter
• IME Physician Letter
• IME Provider List
• IME Territory Map
• Independent Medical Exams
• Physician Instructions
• Record Review Physician Letter
• Rescheduled IME
• Return To Work EvaluationF. Workers' Compensation Appeals Board
Contact: Steven Loux (717-783-7838)• Workers' Compensation Appeal Board—Overview
• Appeal Process (includes Instructions for Completing the Appeal Form and LICB-25/26, Appeal From Judge's Findings of Fact and Conclusions of Law)
• 2021 Hearing Dates
• FAQs
• http://www.dli.pa.gov/Businesses/Compensation/appeals/Pages/default.aspx
G. Interpreter Law, Act 172 of 2006
Contact: James Kayer (717-787-1182)• Model Voir Dire for Qualifying a Non-Certified Sign Language Interpreter or Translator
• Model Voir Dire for Qualifying a Non-Certified Foreign Language Interpreter
• Suggested Oath
• Pennsylvania Code of Ethics and Professional Conduct for Interpreters
• Presiding Officer Checklist
• Interpreter Checklist
• Frequently Asked Questions
• Interpreter's Law Guide: https://www.dli.pa.gov/Individuals/Disability-Services/interpreter/Pages/default.aspx
H. Office of Unemployment Compensation Benefits Policy
Contact: Maria Gray (717-962-4049)• RAM-12 Pamphlet
• BUR-843 Request for Confidential Information
• DUA-5 Disaster Unemployment Assistance
• FP-01 Notice of new TRA Contact Information
• FP-02 Notice of the Health Coverage Tax Credit
• FP-608 RTAA 2015 Election Form
• FP-1099G Statement for Recipients of PA Reemployment Trade Adjustment Assistance (RTAA) Payments
• IB-1 Initial Interstate Claim
• JG-23 PA CareerLink® registration flyer
• UC-2 INS Instructions for Completing PA UC Quarterly Tax Forms
• UC-2D Request for Employer Wage/Credit Week Information
• UC-2D (OOS) Information Request for Combined Wage Claims
• UC-23 Pennsylvania Unemployment Compensation Filing Materials Checklist
• UC-23 (ESP) Pennsylvania Unemployment Compensation Filing Materials Checklist (Spanish)
• UC-24 RESEA Notice
• UC-27 UC Business Card
• UC-42(I) Paper Initial Claim Application
• UC-42(I) (SW) Application Shared-Work Plan (Claimant)
• UC-42(R) Instructions for Reopening a Claim
• UC-42(R) (ESP) Instructions for Reopening a Claim (Spanish)
• UC-44F (Insert) Claimant Certification of Wages
• UC-44F (Insert2) Information Regarding Financial Eligibility
• UC-49 Request for Full-Time Weekly Wage Information
• UC-50 Benefit Exhaustion Letter
• UC-199 Document Retention Notice
• UC-200 Poster Protect Your Business From Higher Taxes
• UC-301 Work Search Warning Letter
• UC-304 Record of Job Applications and Work Search Activities
• UC-304 (ESP) Record of Job Applications and Work Search Activities (Spanish)
• UC-307 Work Search Request Form
• UC-310 Authorization for Direct Deposit
• UC-311 Important Information about Your UC Benefits
• UC-331/UC-331 (ESP) U.S. Bank RELIACARD® Fee Schedule
• UC-332/UC-332 (ESP) U.S. Bank RELIACARD® Fee Chart
• UC-335(1) Invoice for 1st Party research
• UC-335(843) Invoice for 843 research
• UC-335(CA) PA Agency Invoice for 843 research
• UC-335(S1) Subpoena Invoice for 3rd Party research
• UC-335(S2) PA Agency Subpoena Invoice
• UC-335(CS-843) Cost schedule for 843 form
• UC-335(CS-S) Cost schedule for subpoena
• UC-360 Claim Confirmation Letter
• UC-360 CARES Insert
• UC-361 Notary Public Signature (identity verification)
• UC-363 Employer Letter
• UC-365C New PIN Notice
• UC-483 Request for Subsequent Benefit Year Information
• UC-494 Credit Week Information Request
• UC-494(A)
• UC-503 Notice of Court Ordered Withholdings
• UC-503A, UC-503V Cover Letter and Stop Notice for Support Payment Deduction
• UC-503V
• UC-504 SIDES E-response Application
• UC-528 Notice of Exhaustion of UC Benefits
• UC-529 Notice of Expiration of UC Benefits
• UC-600 Poster: Report UC Fraud
• UC-601 Poster: UC Fraud is a Crime
• UC-602 Cheating the System
• UC-700 UC Claims Poster (Private Employers)
• UC-700 (ESP) UC Claims Poster (Spanish)
• UC-700A UC Claims Poster (State Employers)
• UC-701 UC Reduction of Benefits poster
• UC-701 (ESP) UC Reduction of Benefits poster (Spanish)
• UC-723 Important Information about your Eligibility for UC (law changes)
• UC-810 TTY Biweekly Claims Questions
• UC-810(I) TTY Instructions
• UC-988
• UC-1080 Shared-Work poster
• UC-1084 Application Shared-Work Plan (Employer)
• UC-1084(A) Application Instructions
• UC-1088(A) Application Instructions
• UC-1089 Bi-weekly claim form (Employer)
• UC-1091 Application to modify approved Shared-Work Plan
• UC-1099G Statement for Recipients of PA Unemployment Compensation Payments
• UC-1101 Work Search Letter Audit Compliance
• UC-1102 Internet Initial Claim Existing Claim
• UC-1103 Internet Initial Application Wages
• UC-1201 Important Registration Requirement
• UC-1205 Fax Cover Sheet
• UC-1208 Pennsylvania UC Benefits Address Confirmation and Power of Attorney
• UC-1212 PA UC Benefits Address Designation (Non-TPA)
• UC-1290 Notice of Certification Under the Trade Act of 2002
• UC-1290A Notice of Certification Under the Trade Act of 2009
• UC-1290B Notice of Certification Under the Trade Act of 2011
• UC-1290D Notice of Certification Under the Trade Act of 2015
• UC-1295 Trade Act Claim Confirmation
• UC-1298 Instructions for Filing Biweekly TRA Claims
• UC-1299 Selection of Available Insurance Programs
• UC-1609 Employer Information—How to Apply for UC benefits
• UC-1609 (ESP) Employer Information—How to Apply for UC benefits (Spanish)
• UC-1611 Notice of Monetary Eligibility—Combined Wage Claim
• UC-1804 Benefit Reduction to zero
• UCP-1 PA UC Handbook
• UCP-1 Cover Letter
• UCP-1 (ESP) PA UC Handbook (Spanish)
• UCP-8 State Unemployment Compensation and Supplemental Unemployment Benefit Plans
• UCP-9
• UCP-11A Trade Act of 2002 & Reversion 2014
• UCP-11A (ESP) Trade Act of 2002 (Spanish)
• UCP-11B Trade and Globalization Adjustment Assistance Act of 2009
• UCP-11B (ESP) Trade and Globalization Adjustment Assistance Act of 2009
• UCP-11C Trade Adjustment Assistance Extension Act of 2011
• UCP-11C (ESP) Trade Adjustment Assistance Extension Act of 2011
• UCP-16 UC for Reimbursable Employers
• UCP-18 UC Appeals Information
• UCP-18 (ESP)-UC Appeals Information (Spanish)
• UCP-22 RFC for Contributory Employers
• UCP-24 Support Withholding from UC
• UCP-26
• UCP-25 Employee Unemployment Compensation Withholdings
• UCP-32 Employee or Independent Contractor?
• UCP-36 Employers' Reference Guide to Unemployment Compensation
• UCP-39 UC Services for Employers
• UCP-41 UC Eligibility Issues*UCP-41 (ESP) UC Eligibility Issues (Spanish)
• UCP-42 (ES-2762) UC Employer Rights
• UCP-1081 Shared-Work Program pamphlet
• UCP-1082 Shared-Work Program fact sheet
• 2013 PA Unemployment Compensation Amnesty Program/Final Report, April 2014: Make It Right
• 2017 PA Unemployment Compensation Amnesty Program/Final Report, April 2018
• PUA-1099G
• PUA-528I. Office of Unemployment Benefits—Discontinued Non-Regulatory Documents
J. Office of Unemployment Compensation Tax Services
• PA-100 Pennsylvania Enterprise Registration Form and Instructions
• UCMS www.uctax.pa.gov
• UC-2 INS Instructions for Completing PA UC Tax Forms
• UC-746 Records to Be Kept by Employers
• UC-926 Employer Records to be Examined
• UC-2010 File Layouts and Formats for Electronic Reporting of PA Quarterly Unemployment Compensation Wage and Tax Data
• UCP-7 The Problem of ''Localized'' and ''Nonlocalized'' Employment
• UCP-16 UC for Reimbursable Employers
• UCP-32 Employee or Independent Contractor?
• UCP-35 Family Employment
• UCP-36 Employer's Reference Guide to UC
• UCP-40 Controlling UC Costs for Contributory Employers
K. Unemployment Compensation Board of Review
• ''Important Information Regarding UC Law and Regulations'' (temporary)
• UC-46A Board appeal form
• UC-46B Petition for Appeal and UC-1627 Translation notice is owned by the service center but not listed for OUCB. Website is located at: http://www.uc.pa.gov/appeals/Pages/default.aspxL. Bureau of Labor Law Compliance
Contact: Bryan Smolock, Director (717-787-0606)
• Child Labor Complaint Form—LLC-21
• Application for Minors in Performances—LLC-12
• Abstract of Child Labor Act—LLC-5/LLC-5(ESP)
• Special waiver Request for entertainment in Performances—LLC-76
• Prohibited Occupations under the Child Labor Act
• Equal Pay Law
• Industrial Homework Law—Industrial Homework Application/Application Renewal
• Industrial Homework Certification
• Medical Fee Act
• Minimum Wage Act—Minimum wage complaint form
• Overtime Rules in Pennsylvania
• Wage Payment and Collection Law
• Personnel File Inspection Act
• Prevailing Wage Act
• Wage Rate Submittal Form
• Seasonal Farm Labor Act—Contractor/Agent LLC—6 Applications for Farm Labor
• Prevailing Wage Statistics and Collections
• Labor Standards Statistics and Collections
• Prevailing Wage Rate Determination Search (online)
• Prevailing Wage Determination Request Form (online)
• Prevailing Wage Act
• Prevailing Wage Regulations
• Current Labor & Industry debarment list [updated]
• Certified Payroll Certificate
• Apprenticeship and Training Regulations
• Prevailing Wage Complaint Form Electronic Online Version (PW) Printer Friendly (PDF Download) Spanish Version (PDF Download)
• Labor & Industry Road Construction Interpretation
• Check form list
• Definitions for 29 County Building Common Journeyperson Construction Laborers
• Definitions for 29 County Heavy, Highway Construction Laborers [revised]
• Definitions for 7 County Building Construction Operators
• Definitions for 22 County Building Construction Operators
• Definitions for 29 County Heavy Equipment Operators
• Definitions for 29 County Highway Construction Operators
• Definitions for 33 County Building Common Journeyperson Laborers
• Definitions for 33 County Heavy & Highway Laborers [revised]
• Definitions for 33 County Building Operators
• Definitions for 33 County Heavy & Highway Operators
• Definitions for 5 County Building Common Journeyperson Laborers
• Definitions for 5 County Heavy & Highway Laborers [revised]
• Definitions for 5 County Building, Heavy, Highway Operators
• Electrician Lineman notes (statewide)
• Asbestos Removal—Asbestos Worker/Laborer
• Truck Driver (Building, Heavy, Highway)
• Painters (Building, Heavy, Highway)
• Mandatory Workplace Postings for Minimum Wage and Prevailing Wage
• Act 102 Prohibition of Excessive Overtime in Health Care Act Frequently Asked Questions
• Act 102 Prohibition of Excessive Overtime in Health Care Act PowerPoint
• Act 102 Prohibition of Excessive Overtime in Health Care Act Complaint Form
• Act 102 Prohibition of Excessive Overtime in Health Care Act General Overview
• Regulations Governing the Employment of Minors in Performances
• Act 72 Construction Workplace Misclassification Act Workplace Poster in English and Spanish
• Act 72 Construction Workplace Misclassification Act Complaint Form in English and Spanish
• Act 72 Construction Workplace Misclassification Act Summary in English and Spanish
• Act 72 Construction Workplace Misclassification Act Copy of Law
• Solar Panel Classification Information
• Personnel File Complaint FormMonthly reports that summarize the activity of the Bureau on a monthly basis:
• Prohibition of Excessive Overtime in Health Care Act (PowerPoint)
• Bureau of Labor Law Compliance (Prevailing Wage Act PowerPoint)
• Covid-19 FAQs (online)
• Bureau FAQs (online)
• Subminimum Wage application (Minimum Wage Law)M. Bureau of Mediation
Contact: William D. Gross, Director (717-787-2803)
• Grievance Mediation pamphlet
• Pennsylvania Bureau of Mediation pamphlet
• Steward & Supervisor Training pamphlet
• Timed Mediation pamphlet
• Dispute Notice LIMS-102
• Pennsylvania Public Employe Relations Act (195) Notice to Bureau of Mediation LIMS-103
• Act 88 Amendment to the Public School Code of 1949 Notice to Bureau of Mediation LIMS-104
• Request for Grievance Arbitration Panel LIMS-115
• Request for Grievance Mediation LIMS-15N. Bureau of Occupational and Industrial Safety
Contact: Matthew W. Kegg, Director, BOIS (717-783-6304)
• Accessibility-Only Plan Reviews and Inspections
• Building Code Official (BCO) Certification. Revised November 14, 2007
• Ground Snow Loads. Revised June 28, 2007
• Health Care Facilities Act
• Manufactured Housing
• One- and Two-Family Dwelling Fire Protection of Floors. Issued August 1, 2011
• One- and Two-Family Dwelling Sprinkler Installation. Issued August 1, 2011
• Recreational Cabin Exclusion
• Sprinkler System Shop Drawings
• ''State-Owned Buildings''
• Temporary Structures. Revised on January 19, 2011
• Townhouse Sprinkler Installation. Revised on August 1, 2011
• Utility Service Connections
• Accessibility Directives
• Accessibility Requirements in Certain Townhouses
• Accessibility Requirements When Adding Non-Grade Level Floors
• Additions and Accessible Exits
• Measuring Kitchen Base Cabinets for an ''Obstructed High Side Reach Range''
• Public Pools and Accessible
• Temporary Certificates of Occupancy & Accessibility
• Vending and Lottery Machine Reach Ranges
• Advisories on Elevators & Other Lifting Devices
• Building Approval Information
• New Construction vs. Alterations
• UCC Requirements for Elevators Used for Construction Permit
• Variances
• VRCs
• Wheelchair and Stairchair Lifts
• Work/Equipment in Machine Rooms
• PSF-38 Pennsylvania Tier II Emergency & Hazardous Chemical Inventory
• Toxic Release Inventory (TRI) Invoice
• Asbestos ''Roofing'' letter, dated July 1, 1999
• Bedding and Upholstery/Stuffed Toys Frequently Asked Questions
• Monthly BU Renewal AttachmentO. Industrial Board
Contact: Traci Willman, Administrative Officer (717-787-6114)
• Board description
• Appeal/Variance/Extension of Time Procedures
• Meeting Dates
• FAQs
• LIIB 115 Fire and Panic Industrial Board Petition form
• LIIB 117 Uniform Construction Code Industrial Board Petition form
• LIIB 119 Request for Industrial Board Plans form
• LIIB 121 Flammable and Combustible Liquids Industrial Board Petition form
• LIIB 122 Liquefied Petroleum Gas Industrial Board Petition form
• LIIB 303 Boiler Industrial Board Petition form
• LIIB 304 Water Heater Industrial Board Petition form
• LIIB 305 Unfired Pressure Vessel Industrial Board Petition form
• LIIB 306 Bedding & Upholstery Industrial Board Petition form
• LIIB 307 Stuffed Toy Industrial Board Petition formP. Elevator Safety Board
Contact: Traci Willman, Administrative Officer (717-787-6114)
• Board description
• Meeting Dates
• Appeal/Variance/Extension of Time Procedures
• LIIB 112 Elevator Safety Board Petition
Department of
MILITARY AND VETERANS AFFAIRS
(DMVA)
I. POLICY STATEMENTS
• Standard Operating Procedures for the State Armory Board
• Information Paper for the Operation of the Keystone Conference Center
• Housing and Keystone Conference Center Committee Charter
• Privately Owned Weapons on National Guard Facilities
• Public Affairs Airlift Policy
• Military Aircraft Flyovers
• Use of Military Equipment for Civilian Organizations
• Recreational Access to Fort Indiantown Gap
• Resident Abuse Policy and Procedures
• Handbook of Accounting Manual for State Veterans' Homes
• HIPAA Policies and Forms for State Veterans' Homes
• Standard Operating Procedure for Armory Rentals
• Policy for State-Owned Family Housing
• Policy on Maintenance and Use of Veterans' Trust Fund
• Contract Compliance Policy Statement
• Emergency Evacuation Plan
• Equal Opportunity Plan
• EEO Statement
• EEOC/PHRC Complaints
• Sexual Harassment Policy
• Disability-Related Employment Policy
• Discrimination Complaint Process
• Workforce Analysis Summary
• HIV/AIDs Policy Statement
• Incident Investigation and Reporting for Workers Compensation
• IT Policies and Procedures
• PA Worker and Community Right to Know Training Booklet
• Safety Policy
• General Safety Standards
• AIPP Employee Safety Suggestion and Compliance Program
• Smoking and Tobacco Policy—TAG Policy
• Standards of Conduct and Work Rules—TAG Policy
• Workplace Violence and Workplace Bullying Prevention Policy
• OT/Compensatory Leave Policy
• Pre-Employment Drug Testing Policy
• Automated Time Collection System Policy
• DMVA Return to Work Program
• Employee-Related Issues/ConcernsII. INTERNAL GUIDELINES
• Adherence to Work Hours/Wear of Military Uniform
• Bomb Threat Plan—DMVA contains classified information
• Curtailment of Activities at FTIG Due to Inclement Weather
• Political Activity
• Retired Guardsmen Involvement
• Notification of VIP Visits for FTIG and DMVA Organizations
• Pennsylvania National Guard Military Regulations and Directives (PMR/PaANGR)
• Manual for Courts-Martial under PCMJIII. OTHER/GUIDANCE/INSTRUCTIONAL MANUALS
• Military Family Relief Assistance Program Guidelines Personnel Manual
• Index of Administrative Publications (contains classified information) Pamphlet 310
• Military Publications Index of Blank Forms (contains classified information) Pamphlet 25-32
• Training Guidelines Manual
• Organizational and Functional Statement for the DMVA
• Patient Care Policy Manual, Veterans' Homes
• State Home Construction Grant Program
• Veterans Administration Guidelines for State Veterans' Homes
• Directory of Agencies Providing Information to Veterans
• Pennsylvania Veterans' Memorial
• Telephone Directory for Veterans OrganizationsDepartment Contact: Office of Policy, Planning, and Legislative Affairs, Bldg. 7-36 Fort Indiantown Gap Annville, PA 17003 RA-MVDMVALEGISLATIVE@pa.gov
Pennsylvania
COMMISSION ON CRIME AND DELINQUENCY
(PCCD)
I. Office of Criminal Justice System Improvements
• U.S. Department of Justice, Bureau of Justice Assistance, ''Byrne Formula Grant Program Guidance''
• U.S. Department of Justice, Bureau of Justice Assistance, Fact Sheets
• Minimum Operating Standards for Criminal Justice Advisory Boards (CJABs)
• Minimum Operating Standards for Reentry Coalitions
• Intermediate Punishment Program Minimum Standards
• § 9806 County Intermediate Punishment Plan (Outline)
• Intermediate Punishment Information Sheet
• Intermediate Punishment Program Authorization form
• Coronavirus Emergency Supplemental Funds (2020)
• Capital Case Indigent Defense (2020)
• County Jail-Based MAT Training and Technical Assistance (2020)
• Gun Violence Reduction Initiative (2019)
• National Crime Statistics Exchange (NCS-X) (2018)
• PA Opioid Overdose Reduction Technical Assistance Center (2020)
• National Criminal History Improvement Grants (2018, 2019, 2020)
• Adams Walsh Act Initiative (2019)
• Byrne JAG Reallocation Funds (2019, 2020)
• Body Worn Cameras Initiative (2018, 2019)
• CJAB Technical Assistance (2020)
• Comprehensive Opioid Abuse Program (2018, 2019, 2020)
• County Intermediate Punishment Programs 2021-2022
• County Jail-Based Vivitrol Program (2019)
• County Jail-Based MAT Program (2019)
• County Adult Probation and Parole Grant-in-Aid (2020-21)
• PCPA Offender Identification/Accreditation/PAVTN Support (2019)
• PCPA Latent Evidence Project (2019)
• Drug Courts Initiative (2019)
• Project Safe Neighborhoods Western District (2018, 2019)
• Project Safe Neighborhoods Middle District (2018, 2019)
• Project Safe Neighborhoods Eastern District (2018, 2019)
• RSAT (2018, 2019, 2020)
• John R. Justice (2020)
• Stepping Up Technical Assistance Center Initiative (2020)
• Substance Abuse Education (SAEDRF) Category 1
• Substance Abuse Education (SAEDRF) Category 2 & 3
• Training Initiatives-PDAI (2019/2020)
• Training Initiatives-PA Defender Association of PA (2019/2020)II. Constables Education and Training Board
• Constables' Training Bulletins and Annual Reports (August 1994 to Present)
• Constables' Education and Training Board (CETB) instructor information produced solely for contractor schools (Updated Nov. 2007 and adopted by the CETB as an official policy.)
• CETB/PCCD Policy on Act 233 Payments
• PA Constables' Classroom Code of Conduct (Updated Sept. 2019)
• Constable Record Form
• Criteria for instructors as listed on constables' certification application (Updated August 2016)
• Constable Background Check Form
• Act 49 Constable Training Grievance Form
• Basic, Continuing Education, Firearms, Optional and Transfer Enrollment Forms
• Request for Basic and Continuing Education Waiver FormsIII. Sheriff and Deputy Sheriff Education and Training Board
• Deputy Sheriffs' Training Bulletins and Annual Reports. (April 1990 to Present)
• Deputy Sheriffs' Education & Training Board (DSETB) Policy (Updated September 2019)
• Code of Conduct for deputy sheriffs training, distributed by training contractor to trainees in each basic training and waiver class. (Updated September 2019)
• Sheriff offices now submit new hires thru the Sheriff & Deputy Sheriff Information System (SDSIS) (formerly identified here as ''Employment Forms'')
• Basic Training Physical Form
• DSETB Instructor Application
• Sheriff offices now submit waiver requests through the Sheriff & Deputy Sheriff Information System (SDSIS) (formerly identified here as ''DSETB Time & Training Waiver Applications'')
• DSETB Physical Training Standards
• COVID-19 Certification Form for training (May 2020)IV. Office of Financial Management and Administration
• PCCD Applicant's Manual and related documents on PCCD's website
• U.S. Department of Justice, Office of Justice Programs Financial Guide
• 2 CFR Part 200 Uniform Guidance
• Commonwealth of Pennsylvania, Governor's Office, Management Directive 305.20, Grant Administration
• Funding guidelines disseminated as needed by various offices
• Federal award documents and associated conditions posted on PCCD's website
• PCCD Policy for Addressing Complaints Regarding Inherently Religious Activities
• Memo from the Federal Office of Management and Budget regarding ACORN
• Revised Standard Subgrant Conditions
• Federal Funding Accountability and Transparency Act guidance
• Time and Effort Reporting Standards
• Fiscal Accountability Guidelines
• PCCD Civil Rights Compliance Procedures.
• PCCD Discrimination Complaint Form.
• Department of Justice Office For Civil Rights Training for Grantees
• Grants Management Training PowerPoint
• Grants Information Frequently Asked Questions
• Time and Effort Reports Frequently Asked Questions
• PCCD Egrants New User Quick Start Guide
• PCCD Egrants Agency Registration Request Form
• PCCD Egrants New User Role Request Form
• PCCD Egrants User Manager Help Guide
• PCCD Egrants Application Quick Start Guide
• PCCD Competitive Grant Process Overview
• Clearance and Endorsement of Certain Grant Applications
• PCCD Concept Paper and Grant Application Technology Conditions
• PCCD Privacy Certificate and Confidentiality Requirements
• Monitoring Training
• Reporting Potential Fraud, Waste and Abuse
• Acceptable Personal Services Contract
• Pass-Through Agreement
• Employee Time Certification
• Completed Sample Timesheet
• Timesheet Template
• Property Transfer Request Form
• JAG Local Jurisdiction Waiver FormV. Office of Juvenile Justice and Delinquency Prevention
• Pennsylvania Juvenile Justice System Enhancement Strategy Monograph (2012)
• Advancing Balanced and Restorative Justice through Pennsylvania's Juvenile Justice System Enhancement Strategy (2015)
• Blueprints for Healthy Youth Development
• Joint Policy Statement on Aftercare (2005)
• Mental Health/Juvenile Justice Joint Policy Statement (2006)
• Models for Change
• Building Pennsylvania's Comprehensive Aftercare Model Probation Case Management Essentials for Youth in Placement (2008)
• Cost-Benefit Analysis for PCCD's Evidence-Based Initiatives
• 2019 Pennsylvania Juvenile Justice and Delinquency Prevention Plan
• Juvenile Defender Association of PA for Statewide Defender Training Project (2019)
• 2020-2021 PA Academic and Career/Technical Training Funding Announcement
• OJJDP Substance Abuse Education and Demand Reduction Research-Based Funding Announcement (2018, 2019, 2020/2021)
• Violence & Delinquency Prevention Programs Funding Announcement (2018, 2019, 2020)
• JJSES Training and Technical Assistance Project (2019, 2020)
• Secure Compliance Monitoring Project (2019, 2021)
• Defender Association of Philadelphia for the DMC Youth/Law Enforcement Corporation (2018)
• EPISCenter/Standardized Program Evaluation Protocol
• SPEP Project at Vanderbilt University (2018, 2021)
• A Validation of SPEP in Pennsylvania: A Brief Summary
• Summary of the Results of SPEP Validation Study: Final Report
• SPEP Score Interpretation and SPEP Scores
• 2020 PA Start Messaging Campaign Funding Announcement
• 2020 Safe2Say Something Conference Support Funding Announcement
• Georgetown 2020 RED Certification Program Funding Announcement (2020)
• EPIS 2020-2022 Prevention Initiative (2020)
• Guidelines for the administration of the 2019 Pennsylvania Youth Survey—Survey Coordinator Training Instructions and Proctor Script/Instructions
• Pennsylvania Youth Survey (1989 to Present)
• Opioid Misuse Prevention Project Continuation Awards (2021)
• Support for Implementing the Screening, Brief Intervention, and Referral for Treatment (SBIRT) Program (2021)
• Training and Technical Assistance for Expanding the Use of Evidence-Based Programs in Schools (2021)VI. Office of Victims' Services
A. Victims Compensation
• Victims Compensation Claim Form (Standard) (Updated 4/21)
• Victims Compensation Claim Form (One Page) (Updated 4/21)
▪ Spanish (Updated 4/21)
▪ Vietnamese (created 5/21)
▪ Russian (created 5/21)
▪ Chinese (created 5/21
▪ Korean (created 5/21)
▪ German (created 5/21)
• Spanish Signature Page (Updated 11/06)
• Financial Assistance for Victims of Crime pamphlet (English 6/10, Spanish 02/11 and Braille)
• Compensation Resource Guide for Victim Service and Allied Professionals brochure (English and Spanish) (Updated 3/12)
• Victim Advocate Manual—rewritten 2014 and merged with Standard Operating Guidelines (Continual Updates)
• DAVE Brochure for online access of compensation claims (Updated 01/15)
• 40th Grand Jury Archdiocese of PA VCAP Fact Sheet (Created 8/18)
• Restitution/Compensation Brochure (5/08)
• Stolen Benefit Cash Claim form (Updated 4/09)
• Vehicular Claim Addendum Form (Updated 3/07)
• Large Print VCAP Short form (Updated 4/06)
• VCAP Victim Response Surveys (Updated 2016)
• Emergency Compensation Award Application (updated 8/10)
• Protocols and Billing Procedures for Forensic Rape Examinations (Updated 4/19)
• Handout Pads (English and Spanish) and Braille (Updated 12/07)
• VCAP Posters (2015)
• Law Enforcement Fact Sheet (4/08)
• Relocation Expenses (1/16)
• Law Enforcement Victims' Rights Notification Guide (updated 3/21)
o ENGLISH Guide, Postcard (3/21)
o ENGLISH Guide, One Page—Front (3/21)
o ENGLISH Guide, One Page—Front and Back (3/21)
o SPANISH Guide, Postcard (3/21)
o SPANISH Guide, One Page—Front (3/21)
o SPANISH Guide, One Page—Front and Back (3/21)
• SAVIN Poster (English/Spanish)
• SAVIN Brochure (English) (10/10)
• SAVIN Brochure (Spanish) (10/10)
• SAVIN Brochure (Bosnian) (10/10)
• SAVIN Brochure (Mandarian) (10/10)
• SAVIN Brochure (Vietnamese) (10/10)
• SAVIN Brochure (Russian) (10/10)
• SAVIN Tear-Off Pad (English/Spanish)B. Victims Services
• STOP Violence Against Women Formula Grant Program, 2019-2020
• STOP Violence Against Women Formula Grant Program, 2021
• STOP Violence Against Women Model Response to Sex Trafficking, 2019-2020
• STOP Violence Against Women Rural Capacity Building, 2019-2020
• STOP Violence Against Women Rural Capacity Building, 2021
• PCADV STOP 2019-2020 (extended thru 2021)
• PCAR STOP 2019-2020 (extended thru 2021)
• STOP Judicial 2019 (extended thru 2021)
• STOP PAVTN Modules 2019-2020 (extended thru 2021)
• STOP OVA—Enhance Probation and Parole Response to DV 2019-2020 (extended thru 2021)
• Rights and Services Act (RASA)/Victims of Juvenile Offenders (VOJO) Funding
Announcement, 2019-2020
• Rights and Services Act (RASA)/Victims of Juvenile Offenders (VOJO) Funding
Announcement, 2021-2022
• Victims of Crime Act Non-Competitive, 2019—2021
• Victims of Crime Act Competitive # 3, 2019—2021
• Victims of Crime Act Non-Competitive, 2020—2023
• Statewide Crisis Response Initiative Funding Announcement, 2018—2020
• Statewide Crisis Response Initiative Funding Announcement, 2020—2022
• Sexual Assault Services Funding Announcement, 2019-2020
• Sexual Assault Services Funding Announcement, 2020-2021
• PDAI-PA SAVIN Maintenance Funding Announcement, 2020-2021
• Pennsylvania Victim Services Training (PVST) Online Learning Management System, 2020—2022
• PA Department of Aging Hotline & Technology Grant, 2020—2022
• Antiterrorism & Emergency Assistance Program (AEAP), 2020—2022
• Pennsylvania's STOP Implementation Plan, 2017—2021
• Office of Victim Services Monitoring Guidelines Revised 2020VII. Office of Research, Evaluation and Strategic Policy Development
• Justice Reinvestment Initiative: Maximizing State Reforms—U.S. Department of Justice/Bureau of Justice Assistance
• Criminal Justice Population Projections Committee Annual Report
• Population Projection System Update—2018
• NCA Member Child Advocacy Centers (2017—2021)
• PA Chapter of CACs and MDITs (2016—2021)
• Emerging CACs and MDITs (2016—2020)
• CACs in PA and Drive-time Analysis Map
• Child Advocacy Center and MDIT Development (2017, 2018)
• Child Advocacy Center Statewide Plan Development: Technical Assistance to the Commonwealth of Pennsylvania
• Endowment Act—Prevention (2017, 2021)
• Endowment Act—Child Advocacy Centers (2015-2016, 2018-2019, 2020)
• Endowment Act—Direct Victim Services Org. (2015-2016, 2018-2019, 2020)
• Endowment Act—Programs Assisting Victims (2015-2016, 2019)
• Endowment Act—Treatment Training (2015-16, 2018-2019, 2021)
• Endowment Act Planning Session Results (2015—2021)
• Endowment Act—CACs and Victim Service Providers 2019
• Notice of Proposed Expenditures Letters for Endowment Act (2015—Present)
• Endowment Act Grant Applications Recommended Maps (2015—Present)
• Endowment Act Interactive Map (2016—2021)
• Model Set of Standards for Pennsylvania's Multidisciplinary Investigative Teams
• 2018 PDAI MDIT Training Symposiums and Webinars
• National Children's Alliance Accreditation Guidelines for Children's Advocacy Centers
• National Children's Alliance Standards for Accredited Members
• Non-Profit Security Grant Funds (2020, 2021)
• Pennsylvania Consolidated Victim Service Program Standards
• Pennsylvania Coalition Against Rape Standards
• Using Mental Health Screening Tools with Child Trauma Survivors
• The Safe and Healthy Communities Initiative: Implementation Guide
• Program Income for Child Advocacy Centers Webinar
• Outcomes Framework for CACs
• TF-CBT Advanced Training Report
• CSEC Survivors Forum Summary
• CACAC response to Council on Reform
• State CAC Outcomes Report (2016 through 2021)
• Endowment Act Outcomes Report (2016 through 2021)
• CACAC Memo on Legislative Recommendations
• School Safety and Security Assessment Criteria and Overview
• School Safety and Security Survey
• School Safety and Security Grant Program (2018 and 2019) Funding Announcements
• Community Violence Prevention/Reduction (2018, 2019, and 2020) Funding Announcements
• COVID-19 School Health and Safety Grants for 20-21 (2020), both for public schools and intermediate units on behalf of nonpublic schools) Funding Announcements
• School Safety Provider Registry and Guide
• School Security Guard Vendor Registration
• School Security Personnel Training Standards
• Threat Assessment
▪ Model K-12 Procedures and Guidelines;
▪ Guidance on Communication and Information on Confidentiality;
▪ Information for School Staff, Parents, and Guardians;
▪ Threat Assessment Team Training;
▪ Information for School Students; and
▪ Technical Assistance and Training Network
• Model Trauma-Informed Approach Plan
• Students Preventing Violence in School
• Grant Guides
• Baseline Criteria
Pennsylvania
HOUSING FINANCING AGENCY
(PHFA)
I. POLICY STATEMENTS
• Rental Housing Program
12 Pa. Code, Sections 31.11—31.25
Contact: Holly Glauser (717.780.3876)• Owner-Occupied Residential Housing Program
12 Pa. Code, Sections 31.101—31.105
Contact: Kate Newton (717.780.3891)
• Mortgage Loan Program
12 Pa. Code, Sections 31.111—31.117
Contact: Kate Newton (717.780.3891)• Policy Statement on Homeowners' Emergency Mortgage Assistance Program (including Program Guidelines, Act 91 Notice (as updated 2016))
12 Pa. Code, Section 31.201 et seq.
Contact: Lori Toia (717.780.3945)• HEMAP Consumer Credit Counseling Agencies on
PHFA website at www.phfa.org
Contact: Lori Toia (717.780.3945)• Privacy Policy
Contact: Tom Brzana (717.780.3996)II. GUIDANCE MANUALS
A. Development Division• PHFA Multifamily Housing Application and Guidelines (contains PennHOMES, Taxable and Tax-Exempt Financing and Low Income Housing Tax Credit Guidelines)
• PHFA Preprocessing Manual for Projects with Agency Federal HOME Funds
• PHFA Preprocessing Manual for Projects with Agency Reserve Funds
Contact: Lisa Lutz (717.780.3876)B. Technical Services Division
• Architectural Submission Guide
• PHFA Preconstruction Meeting Guide
• General Payout Procedures for Mortgagors & Contractors
Contact: Kristy Provost (717.780.1846)C. Housing Management Division
• PHFA Property Operations Manual
• PHFA Section 8 Non-Performance Based Property Operations Manual
• PHFA Low-Income Housing Tax Credit Compliance Manual
Contact: Barbara Huntsinger (717.780.3818)• PHFA Financial Reporting Manual for Agency Financed Properties and Tax Credit Only Properties (No Agency Financing)
Contact: Kathy Hughes (717.780.3819)D. Housing Services Department
• Senior Supportive Services Program Manual with PennHOMES/Low Income Tax Credit Requirements
• Supportive Services Program Manual with Section 8 Requirements
• Family Supportive Services Program Manual with PennHOMES/Low Income Tax Credit Requirements
• Family Supportive Services Program Manual with Philadelphia Family Resource Center Initiative Requirements
• Family Supportive Services Program Manual with Philadelphia Escrow/Waiver Requirements
• Quick Connections (supportive services newsletter)
Contact: Melissa Reifsnyder (717.780.4353)E. Single Family Housing Division
• PHFA Seller's Guide
Contact: Kate Newton (717.780.3891)
• Renovate & Repair Program Guidelines
Contact: Roberta Schwalm (717.780.3838)
• Pennvest Homeowner Septic Loan Program Guidelines
Contact: Roberta Schwalm (717.780.3838)III. INTERNAL GUIDELINES
• PHFA Board Agenda, Minutes and Resolutions
• Bylaws of the Pennsylvania Housing Finance Agency
• PHFA Right to Know Act Policy
• PHFA Investment Policy
• PHFA Interest Rate Swap Guidelines
Contact: Carrie Barnes (717.780.3911)
• PHFA Employee Manual
Contract Susan Delgado (717.780.3882)
• PHFA Fraud Detection, Prevention, Escalation and Resolution Policy
• PHFA Quality Assurance Plan for Residential Mortgage Loan Programs
• PHFA Secondary Market Interest Rate Risk Management and Hedging Policy
Contact: Kate Newton (717-780-3891)V. OTHER
• Anti-Predatory Lending
• Anti-Predatory Lending and Foreclosure Prevention Presentation—CD-Rom
• Anti-Predatory Lending and Foreclosure Prevention—Trainer's Guide
Contact: Terri Redmond (717.780.3835)
• PHFA Annual Report
• Pennsylvania Housing Studies (available only on website at www.phfa.org)
• Employer Assisted Housing (EAH) Initiative
• PHFA Homebuyer Workbook
• Do-Able Renewable Home (Accessibility Workbook)
Contact: Chris Anderson (717.780.3815)
• Financial Reporting Information
Contract either Joseph Knopic (717.780.3826) or Heather Shull (717.780.3886)A. PHFA Brochures
• Programs for Homebuyers
• Housing Counseling and Education
• Don't Get Hooked by Predatory Lending
• Foreclosure Prevention
• PAHousingSearch.com
• Mortgage Tax Credits
• PENNVEST Homeowner Septic Program
• Why Should I Choose a PHFA Mortgage
• Renovate & Repair Loan Program (R&R) (available only in the website at www.phfa.org)
• Multifamily Development and Rental Housing
• Help with Housing (general PHFA brochure)
• Employer Assisted Housing (EAH) Initiative
Contact: Chris Anderson (717.780.3815)B. PHFA Program Notices
• PHARE Plan & RFP
Contact: Melissa Raffensperger (717.780.3947)
• National Housing Trust Fund Program
Contact: Holly Glauser (717.780.3994)
• Manufactured Home Community Rights Act Notice
Contact: Legal Department (717.780.3846)
• HEMAP-Revised Act 91/6 Program Notice (and alternative language notices)
Contact: Lori Toia (717.780.3945)C. Programs for Home Buyers
• HFA PreferredTM and HFA Preferred Risk SharingTM
• Keystone Home Loan
• Keystone Government Loan
• Keystone Advantage Assistance Loan
• HOMEstead Assistance Loan
• Access Modification and Access Assistance Loans
• Mortgage Credit Certificate
Contact: Kate Newton (717.780.3891)D. Programs for Home Owners
• Mortgage Refinancing
Contact: Kate Newton (717.780.3891)
• Renovate and Repair Program
• PENNVEST Homeowner Septic Program
• Homeowners Energy Efficiency Loan Program
Contact: Roberta Schwalm (717.780.3838)• Homeowner's Emergency Mortgage Assistance Program (HEMAP)
Contact: Lori Toia (717.780.3945)Additional information on these programs and other resources is available on PHFA's website (www.phfa.org) from time to time (including funding notices, Requests for Proposals, and news and public notices)
Pennsylvania
MUNICIPAL RETIREMENT SYSTEM
(PMRS)
I. POLICY STATEMENTS
• Actuarial Tables
• Allocation of Excess Interest to Municipal Account, Member's Accounts, and Retired
• Business and Educational Travel Policy
• Calculation of Withdrawing Plan's Portion of Retired Member's Reserve
• Contractor Insurance
• Contract & Purchasing Procedures
• Date of Birth Proof
• Delayed Interest Payment Policy
• Designating Signatories
• Disability Reserve Funding
• DROP—Deferred Retirement Option Program
• Excess Interest Award Process
• Indemnification Policy
• Investment Policy Statement
• Missed Contributions Policy Statement
• Overpayment Policy
• Permanent Employee
• Plan Withdrawal Procedures
• Portability: Individual Member
• Portability: Plan Spin-offs
• Proxy Voting Guidelines
• Refund-Plan Withdrawal
• Return to Work Policy Statement
• Right To Know Policy
Contact: Doug Baker (717) 787-2065II. GUIDANCE MANUALS
• PMRS Notes & News
• PMRS Pamphlets:
Plan Benefit Summary (individualized for each municipality)
Evaluating Your Pension Plan
Pennsylvania Municipal Retirement System
• Individual Municipality Plan Benefit Agreements
• PMRS Website: www.pmrs.state.pa.us
Contact: Doug Baker (717) 787-2065III. DECISIONS
• PMRS Board of Trustees Adjudications Topics:
Death Benefit
Disability
Membership Eligibility
Miscellaneous
Payment of Interest
Pension Benefit
Pension Forfeiture
Purchase of Service
Retirement-Covered Compensation
Contact: Doug Baker (717) 787-2065IV. INTERNAL GUIDELINES
• Actuarial Reports (Annual Evaluation and 5-year Experience Study Report)
• Actuarial Tables
• Comprehensive Annual Financial Report
• Investment Consultant Quarterly Reports
• PMRS Board Minutes and Resolutions
• Sample Domestic Relations Order and Instruction Memo
• Template Pension Plan Contract for Police, Municipal and Firefighter
Contact: Doug Baker (717) 787-2065
MUNICIPAL POLICE OFFICERS' EDUCATION AND TRAINING COMMISSION
(MPOETC)
Lethal Weapons (Act 235)
Physical Examination—LWTA (SP 8-200A)
Psychological Examination—LWTA (SP 8-200B)
Lethal Weapons Exemption—LWTA (SP 8-200C)
Renewal of Agent Certification— https://www.tacs.pa.gov/tacs/
Vision Examination—(SP 8-200V)MPOETC (Act 120)
Application for Police Officer Certification Examination: https://www.tacs.pa.gov/tacs/
Physical Examination (MPO-210)
Psychological Examination (MPO-212)
Application for Consideration of Reinstatement of Certification (MPO-213)
Vision Examination (MPO-211)RLEIA (Act 79)
Certified Law Enforcement Firearms Instructor Application
Retired Officer Concealed Carry Acknowledgement FormAll of the non-regulatory, compliance-related documents listed above are available from the Pennsylvania State Police by contacting the Department at the following address or phone number:
Pennsylvania State Police
Bureau of Research & Development
1800 Elmerton Avenue
Harrisburg, PA 17110
(717) 783-5536
Documents are also available from the State Library, Government Publication Section at 219 Forum Building, Harrisburg, PA 17120 and may be obtained through inter-library loan.
Pennsylvania
STATE POLICE
(PSP)
GUIDANCE MANUALS, BROCHURES, FORMS AND OTHER MATERIALS
A. Bureau of Criminal Investigation
• Terrorism Tipline Card
• Business Terrorism Intervention Program (TIP) forms
• Terrorism Tips—Get Involved, Report Homeland Security or Terrorism Tips
• PA TIPLINE: Suspicious Activity Reporting
• CIKR and PACIC Brochure
• Drug Tipline Card
• SAR Brochure—What is Suspicious Activity ReportingB. Bureau of Human Resources & Bureau of Liquor Control Enforcement
• Liquor Enforcement Officer Trainee Brochure (SP 5-348)
C. Bureau of Patrol
• Emergency Vehicle Designation (SP 6-115)
• Child Safety Seat Identification Decal (SP 6-153)D. Bureau of Integrity and Professional Standards
• Complaint Verification Form (SP 1-108)
E. Bureau of Records and Identification
• Information for Pennsylvania Firearms Purchasers and Basic Firearm Safety (SP 4-135)
• Application/Record of Sale (SP 4-113)
• Request for Criminal Record Check (SP 4-164)
• Right-to-Know Law Request (SP 3-226)
• Notice of Crash Investigation and Application to Obtain Copy of Police Crash Report (SP 7-0015)
• Pennsylvania Instant Check System Challenge (SP 4-197)F. Bureau of Research and Development
• Pennsylvania Annual Police Pursuit Report (1998-2019)
https://www.policepursuits.pa.govG. Communications Office
• Child Identification Kit (SP 5-350)
H. Equality and Inclusion Office
• Sexual Harassment, Sexual Misconduct Policy and Complaint Procedures Pamphlet
(SP 5-355)
• Sexual Harassment, Sexual Misconduct Policy and Complaint Procedures Pamphlet-Spanish version (SP 5-355S)I. Bureau of Training and Education—Academy
• Pennsylvania State Police—We Are You (SP 5-359)
All of the non-regulatory, compliance-related documents listed above are available from the Pennsylvania State Police by contacting the Department at the following address or phone number:
Pennsylvania State Police
Bureau of Research & Development
1800 Elmerton Avenue
Harrisburg, PA 17110
(717) 783-5536Documents are also available from the State Library, Government Publication Section at 219 Forum Building, Harrisburg, PA 17120 and may be obtained through inter-library loan.
PUBLIC SCHOOL EMPLOYEES' RETIREMENT SYSTEM
(PSERS)
I. GUIDANCE MANUALS
• PSERS Active Member Handbook (Current Ed. 07/2019)
• PSERS Retired Member Handbook (Current Ed. 03/2014)
• PSERS Pamphlets:
Let's Talk About: Taxes on Your Retirement Benefits (07/2017)
Let's Talk About: Disability Retirement Benefits (06/2016
Let's Talk About: PSERS Death Benefits (10/2018)
• Information for New School Employees (07/2019)
• PSERS Return to Service Exceptions (07/2018)
• PSERS Divorce Guidelines (09/2012)
• PSERS Active Member Newsletter (Vol. 1, 2, 3)
• PSERS Retired Member Newsletter (Vol. 1, 2, 3)
• The Employer Bulletin (Bimonthly)
• PSERS Employer Reference Manual
• Online Estimate Calculator Retirement Planning at your Fingertips
Contact: Evelyn Williams (717) 720-4734II. DECISIONS
• PSERS Board of Trustees Adjudications Topics:
Beneficiary Change
Change Employment Status
Change of Option
Change Retirement Date
Class TD and TF Election
Cost of Living Increase
Credited Years of Service
Death Benefit
Disability
Divorce
Effective Date of Retirement
Emergency Return to Service
Final Average Salary
Frozen Present Value
Forced Maternity Leave
Full-Year Service
Health Care Premium Assistance
Mandatory Membership
Membership Eligibility
Military Service (purchase of)
Multiple Service Credit
Non-Qualifying Part-Time Service
Overpayment
Payment of Interest
Pension Forfeiture
Purchase of Service
Recalculation of Benefit
Reinstatement
Retirement-Covered Compensation
Return to Public School Service
Service Adjustment
Tax Collector
Miscellaneous
Contact: Evelyn Williams (717) 720-4734III. INTERNAL POLICY STATEMENTS and GUIDELINES
• PSERS Board Automation Policy
• PSERS Bylaws
• PSERS Election Procedures and Guidelines
• PSERS Board Ethics Policy
• PSERS Public Market Emerging Investment Manager Program Policy
• PSERS External Board Appointment and Attendance Policy
• PSERS Domestic Proxy Voting Guidelines
• PSERS International Proxy Voting Guidelines
• PSERS Investment Policy Statement, Objectives & Guidelines
• PSERS Public Information Policy
• PSERS Securities Litigation Policy
• PSERS Education Policy
• PSERS Oral Argument Policy
• PSERS Fraud, Waste and Abuse Reporting Policy
• PSERS Business Rules Categories:
Administration of Member Accounts
Appeals
Customer Service
Death
Disability
Disbursements
Divorce
Employer
Enrollment
Estimate
Final Average Salary
Global
Health Care and Premium Assistance
Interest
Leave of Absence
Member
Multiple Service
Nomination of Beneficiary
Pension Forfeiture
Purchase of Service
Receivables
Refund
Required Beginning Date
Retirement
Retirement-Covered Compensation
Return to Service
Superannuation
T-F Election
Contact: Evelyn Williams (717) 720-4734IV. OTHER
• PSERS Website: psers.pa.gov
• PSERS Comprehensive Annual Financial Report (Includes Mission Statement)
• PSERS Summary Annual Financial Report
• PSERS Board Minutes and Resolutions
• PSERS Asset Allocation Plan
• Annual Actuarial Valuation Report
• Actuarial Experience Study Report (5-year intervals)
• Quarterly Financial Statements
• PSERS Budget Hearing materials
• PSERS Budget Report Highlights
• PSERS SEC Form 13F filing
• PSERS Asset Listing (Fiscal Year End)
• Actuarial Tables and Computational Procedures, Pa. Bulletin, Vol. 48, No. 26, pp. 3839—3938, June 30, 2018
• Pennsylvania School Retiree Health Care Coverage
Website: hopbenefits.com
Health Options Program
Premium Assistance Program
Contact: Evelyn Williams (717) 720-4734
Department of
REVENUE
(DOR)
BUREAU OF ADMINISTRATIVE SERVICES, TAX FORMS SERVICE UNIT
1854 BROOKWOOD STREET, HARRISBURG, PA 17104-2244
TELEPHONE: 1-800-362-2050 (Toll-free number)
FAX: (717) 346-1958
DOR WEBSITE: www.revenue.pa.gov• DEX-41—Application for Refund/Rebate Due the Decedent
• DEX-93—Personal Income Tax Correspondence Sheet (available via internet only)
• DFO-02—Personal Income Tax Preparation Guide
• DFO-03—Property Tax/Rent Rebate Preparation Guide
• DMF-76—Liquid Fuels and Fuels Recordkeeping Requirements for Retail Service Stations
• DMF-76A—Liquid Fuels and Fuels Recordkeeping Requirements for PA Registered Distributors
• DMF-101—Alternative Fuels Tax Report
• DMF-105—International Fuel Tax Agreement—Recordkeeping Requirements and Disposition of Decals
• DMF-107—Decal Waiver/Exempt Vehicle Q&A
• PA Schedule 19—Taxable Sale of a Principal Residence
• PA-20S/PA-65 Partnership—PA S Corporation Information Return—(Available only through internet after 2010)
• PA-40—Personal Income Tax Return
PA-40 Schedule A—Interest Income
PA-40 Schedule B—Dividend Income
PA-40 Schedule D—Sale, Exchange or Disposition of Property
PA-40 Schedule E—Rents and Royalty Income (Loss)
PA-40 Schedule J—Income from Estates or Trusts
PA-40 Schedule O—Other Deductions
PA-40 Schedule P—Refund Donations to Pennsylvania 529 College Savings
Program Accounts
PA-40 Schedule SP—Special Tax Forgiveness
PA-40 Schedule T—Gambling and Lottery Winnings
PA-40 Schedule UE—Allowable Employee Business Expenses
PA-40 Schedule W-2S—Wage Statement Summary
• PA-40 ES (F/C)—Declaration of Estimated Tax or Estimated Withholding Tax for Fiduciaries, Partnerships & Other Pass Through Entities
• PA-40 ES (I)—Declaration of Estimated Personal Income Tax
• PA-40 IN—Personal Income Tax Instruction Book—Resident/Nonresident/Part-Year Resident (order by year needed)
• PA-40 NR—Personal Income Tax Instruction Book/Nonresidents (1995 & prior-order by year needed)
• PA-40 Schedule C—Profit or Loss from Business or Profession (Sole Proprietorship)
• PA-40 Schedule F—Farm Income and Expenses
• PA-40/PA-41 Schedule G-L—Calculation of Credit for Taxes Paid to Other States (Long Form)
• PA-40 Schedule NRH—Instructions for Apportioning Income by Nonresident Individuals
• PA-40 V—Payment Voucher (available via internet only)
• PA-40 W-2RW—PA W-2 Reconciliation Worksheet (available via internet only)
• Schedule PA-40 X—Amended PA Personal Income Tax Schedule
• PA-40/PA-41 Schedule OC—Other Credits
• PA-40ESR(F/C)—Declaration of Estimated or Estimated Withholding Income Tax for Fiduciary & Partnerships
• PA-40ESR(I)—Declaration of Estimated or Estimated Withholding Income
• PA-41—Instructions (detailed instructions available via internet only after 2003)
• PA-41—PA Fiduciary Income Tax Return
• PA-41 Schedule A—Interest Income and Gambling and Lottery Winnings
• PA-41 Schedule B—Dividend and Capital Gains Distributions Income
• PA-41 Schedule D—Sale, Exchange or Disposition of Property
• PA-41 Schedule DD—Distribution Deductions
• PA-41 Schedule J—Income from Estates or Trusts
• PA-41 Schedule N—PA Source Income and Nonresident Tax Withheld
• PA-41 Schedule NRK-1—Nonresident Schedule of Shareholder/Partner/Beneficiary Pass Through Income, Loss and Credits
• PA-41 Schedule OI IN—Other Information Instructions
• PA-41 Schedule RK-1—Resident Schedule of Shareholder/Partner/Beneficiary Pass Through Income, Loss and Credits
• PA-41 V—Payment Voucher (available via internet only)
• Schedule PA-41 X—Amended PA Fiduciary Income Tax Schedule
• PA-971—Innocent Spouse Relief
• PA-1000—Property Tax or Rent Rebate Claim
• PA-1000 A—Deceased Claimant and/or Multiple Home Prorations
• PA-1000 B/D/E—Widow or Widower/Public Assistance/Business Use Prorations
• PA-1000 Booklet—Property Tax/Rent Rebate Instruction Book
• PA-1000 F/G—Multiple Owner or Lessor Prorations/Income Annualization
• PA-1000 PS—Physicians Statement of Permanent and Total Disability
• PA-1000 RC—PA Rent Certificate and Rental Occupancy Affidavit
• PA-8379—Injured Spouse Claim & Allocation
• PA-8453—Pennsylvania Individual Income Tax Declaration for Electronic Filing
• PA-8453C—PA Corporate Net Income Tax Declaration for a State e-file Report
• PA-8453F—Pennsylvania Fiduciary Income Tax Declaration for Electronic Filing
• PA-8453-NRC—Nonresident Consolidated Income Tax Return (PA-40 NRC) Tax Declaration for a State e-file Return
• PA-8453P—PA S Corporation/Partnership Information Return—Directory of Corporate Partners Tax Declaration for a State e-file Return
• PA-8857—Request for Relief from Joint Liability
• PA-8879—Pennsylvania e-file Signature Authorization
• PA-8879C—e-file Signature Authorization for RCT-101, PA Corporate Net Income Tax Report
• PA-8879F—Pennsylvania Fiduciary e-file Signature Authorization
• PA-8879-NRC—Pennsylvania e-file Signature Authorization for Nonresident Consolidated Income Tax Return (PA-40 NRC)
• PA-8879P—PA e-file Signature Authorization for PA S Corporation/Partnership Information Return Directory of Corporate Partners
• PA-12507—Innocent Spouse Statement
• PA-12508—Non-Requesting Spouse Information Request for Innocent Spouse Review
• PA-12510—Questionnaire for Relief from Joint Liability for Requesting Spouse
• RCT-101D—Declaration of de minimis PA Activity
• REV-23—Board of Appeals Practices and Procedures Brochure
• REV-39—Sales and Use Tax Appeal Schedule
• REV-65—Board of Appeals Petition Form
• REV-72—Sales Tax Exemption Instructions and Application
• REV-181—Application for Tax Clearance
• REV-183—Realty Transfer Tax Statement of Value
• REV-221—Sales & Use Tax Rate Chart
• REV-227—PA Sales and Use Tax Credit Chart
• REV-238—Out of Existence/Withdrawal Affidavit/Corp Tax
• REV-251—Tax Bulletin 53B and 53F Instructions Foreign Corp Clearance Cert./Withdrawal
• REV-252—Tax Bulletin 53C and 53E Security Clearance Cert./Domestic Out of Existence
• REV-253—Tax Bulletin 53D Instructions for Filing Corp Tax Reports
• REV-276—Application for Extension of Time to File (PIT)
• REV-331A—Authorization for Electronic Funds Transfer Agreement
• REV-346—Estate Information Sheet
• REV-413 (F)—Instructions for Estimating PA Fiduciary Income Tax—For Estates and Trusts Only
• REV-413 (I)—Instructions for Estimating PA Personal Income Tax—For Individuals Only
• REV-414 (F)—Estates and Trusts Worksheet for Estimated Tax
• REV-414 (I)—Individuals Worksheet for Estimated Tax
• REV-415—Employer Withholding Information Guide
• REV-419—Employee's Nonwithholding Application Certificate
• REV-459B—Consent to Transfer, Adjust or Correct PA Estimated Personal Income Tax Account
• REV-467—Authorization for Release of Tax Records
• REV-489—Tips for Successfully Filing PA Schedule UE
• REV-527—Office of Taxpayer Rights Advocate Brochure
• REV-543—PA Distributor's Guide to License Classification
• REV-551—Dyed Diesel Fuel Inspection Notice
• REV-554—Your Rights as a Taxpayer (Disclosure Statement)
• REV-556—Taxpayer Request for Assistance
• REV-563—Business Trust Fund Taxes Responsible Party Information Form
• REV-573—Property Tax/Rent Rebate Brochure
• REV-577—Estimated Tax Payments—For PA Personal Income Tax Brochure
• REV-581—Personal Income Tax Brochure
• REV-588—Starting a Business in Pennsylvania
• REV-611—Determining Residence for PA Personal Income Tax Brochure
• REV-612—Military Pay for PA Personal Income Tax Purposes Brochure
• REV-625—Sale of Your Principal Residence and PA Personal Income Tax Implications Brochure
• REV-631—Tax Forgiveness for PA Personal Income Tax Brochure
• REV-636—Retirement—Traditional IRAs and Roth IRAs Brochure
• REV-637—Unreimbursed Allowable Employee Business Expenses for PA Personal Income Tax Purposes Brochure
• REV-677—Power of Attorney and Declaration of Representative
• REV-679—Tobacco Products Monthly Report
• REV-703—PA Cigarette Tax and Other Tobacco Products Administrative Due Dates
• REV-704—PA Malt Beverage Tax Payment and Report Due Dates
• REV-705—PA Pari-Mutuel Wagering Tax Return and Payment Due Dates
• REV-706—PA Small Games of Chance Administrative Due Dates
• REV-717—Retailers' Information Guide
• REV-748—Electronic Services for PA Businesses
• REV-757—Employer Letter Template
• REV-775—Personal Income Tax Employee Expense Affidavit
• REV-793—Consumer Cigarette Use/Excise Tax Return
• REV-796—PA Mass Transit (PTA/VRT) Returns, Tax Periods, and Administrative Due Dates
• REV-819—Sales Use, Hotel Occupancy Tax Returns, Tax Periods and Administrative Due Dates
• REV-853—Corp Tax Annual Extension Request Coupon
• REV-854—EIN/Tax Year/Address Change Form
• REV-857—Corp Tax Estimated Tax Payment Coupon
• REV-860—Schedule C-5, OA and OD
• REV-861—Schedule DA Disposition of Assets
• REV-915—PA Small Games of Chance Request for Game Approval
• REV-934—Schedule of Nonbusiness Income
• REV-956—Institution of Purely Public Charity Renewal Affidavit
• REV-976—Election Not to be Taxed as a PA S Corporation
• REV-1026—Information on Motor Carriers Road Tax and IFTA
• REV-1026A—Information on Motor Carriers Road Tax-PA Only
• REV-1076—Tax Bulletin 53A Instructions for Securing Bulk Sales Certificate
• REV-1123—Educational Improvement/Opportunity Scholarship Tax Credit Election Form
• REV-1176—e-TIDES Administrative Access Change Request
• REV-1200—CT-1 Corporation Tax Instruction Book (order by year needed)
• REV-1220—Pennsylvania Exemption Certificate
• REV-1329—Corrected School District Code Report
• REV-1500—Instructions for form REV-1500 PA Inheritance Tax Resident Decedent
• REV-1601—Tax Credit Certification Request Form (Pennsylvania Employment Incentive Payment Program)
• REV-1605—Names of Corporate Officers
• REV-1611—Interest Rate and Calculation Method for All Taxes Due After Jan. 1, 1982
• REV-1630—Underpayment of Estimated Tax by Individuals
• REV-1630A—Underpayment of Estimated Tax by Individual Farmers
• REV-1630F—Underpayment of Estimated Tax by Fiduciaries
• REV-1643—Tax-Exempt Obligation for Pennsylvania Personal Income Tax Purposes
• REV-1667—Annual Withholding Reconciliation Statement
• REV-1689—PA Schedule D-1 Calculation of Installment Sale Income
• REV-1705-R—Tax Account Information Change/Correction Form
• REV-1706—Business/Account Cancellation Form
• REV-1716—Period Ending and Administrative Due Dates for the Remittance of Employer Withholding and Filing of Quarterly Returns and W-2 Forms
• REV-1729—Tax Information for Farmers—State and Local Sales and Use Tax Brochure
• REV-1737A—Nonresident Inheritance Tax Return
• REV-1742—PIT Gain or Loss on Property Acquired prior to June 1, 1971/PA Schedule D-71
• REV-1799A—Time Limitations on the Filing of Appeal
• REV-1808—Licensed Manufacturers, Wholesalers & Retailers Reporting Schedule for (RYO) Roll-Your-Own Tobacco
• REV-1809—Consumer Tobacco Products Use/Excise Tax Return for Tobacco Products Purchased on or after October 1, 2016
• REV-1810—PA Medical Marijuana Gross Receipts Tax Due Dates
• REV-1827—PA Consumer Fireworks Tax Due Dates
• REV-1829—PA Wine Excise Tax Due Dates
• REV-1831—Tips for Reporting Common Expenses (Schedule C)
• REV-1832—1099-MISC Withholding Exemption Certificate
• REV-1834—Adjustments for Bonus Depreciation and Deduction
• REV-1840—Hotel Booking Agent Registration Form
• REV-1849—Business Operations Questionnaire
REGULATIONS/PRONOUNCEMENTS
All regulations and revenue pronouncements issued by the Department of Revenue are published in Title 61 of the Pennsylvania Code. The Department does not print these documents. If you need to review a regulation or revenue pronouncement, please consult Title 61 of the Pennsylvania Code (www.pacode.com).
BUREAU OF ENFORCEMENT AND TAXPAYER ASSISTANCE
STRAWBERRY SQ. FLOOR 5, 327 WALNUT ST, HARRISBURG, PA 17128
TELEPHONE: (717) 783-9685• DCI-02—Tobacco Tax for Law Enforcement Brochure
BUREAU OF INDIVIDUAL TAXES
PO BOX 280600, HARRISBURG, PA 17128-0600
TELEPHONE: (717) 787-8346• PA-1436—Electronic Filing Test Package
THE PA LOTTERY
1200 FULLING MILL ROAD, SUITE ONE, MIDDLETOWN, PA 17057
TELEPHONE: (717) 702-8008
(*or from Lottery Retailer Outlets)• *All-Game Guide Brochure
• Compulsive Gambling Brochure
• Benefits and Rights for Older Pennsylvanians Booklet
• *RSL-3—Lottery Retailer License Application
• *RSL-209—Standard Claim Form
• *RSL-355—Beneficiary Statement
• *RSL-400—Lottery Fund Benefits Programs Brochure Comparative Statement of Income and Expenditures
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