PA County Ratification Paperwork Submission Form
*refer to the PGSD website for detailed ratification information
Date
-
Month
-
Day
Year
Date
Name
*
Presiding Officer's First and
Last Name
County
State
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Lawful Component
Yes, complete
Operational Component
Yes, Complete
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