Forms & Documents Page ContentCTRL + F to search for forms and documents on this page Area Agency on Aging CSP BrochureLebanon County Annual Enrollment EventNon-Medical Home Care / Home Health / Hospice AgenciesNursing, Residential & Retirement HomesPA Department of Aging Waiver Fact SheetPA MEDI BrochurePersonal Care HomesPrograms that Could Help Save Money on Your Monthly PremiumsRespite Care Facilities Assessment Office Appeal Rules & RegulationsBoard of Assessment AppealClean and Green ActClean and Green ApplicationCover Letter for UPI VerificationFormal Appeal Withdrawal FormHomestead ApplicationIntent to Appeal FormRules for Verification of UPI NumbersUnderstanding the Clean and Green Program (Hidden) Children and Youth Services Clerk of Courts Change of AddressClerk of Courts Fee Schedule 2022Clerk of Courts SubpoenaExpungement ProcedureNotice of Appeal from Summary Criminal Conviction - SAMPLENunc Pro Tunc InstructionsNunc Pro Tunc Petition and Order Commission for Women Sponsorship Opportunities 2018.pdf2019 HOF Nomination form.pdf2017 Hall of FameBoard Members ListingBylawsVision and Mission StatementWomen's Groups in Lebanon County Commissioners' Office 2015 Budget2016 Budget SummaryMonument Park Public Events Application/Questionnaire Commission on Drug and Alcohol Abuse Lebanon County Comission on Drug and Alcohol Abuse - 2014-2015 Annual Report Community Action Partnership Short-Term Rental and Shelter Assistance Application (Hidden) Conservation District (Hidden) Controller's Office (Hidden) Cooperative Extension (Hidden) Coroner's Office Court System Waiver of Arraignment.pdf2017 Court Calendar2019 Court Calendar2020 Court CalendarAcceptance of ServiceADA Policy/Forms for Lebanon County CourtsAffidavit of ConsentAffidavit of Nonmilitary ServiceAffidavit of ServiceAffidavit under Section 3301(d) & Certificate of ServiceAttorney ListCertificate of Trial Readiness FormCivil and Family Interpreter Request FormCivil Cover SheetCivil Division RulesComplaint under Section 3301(c) or (d) of Divorce CodeComplaint with Count 1 - Alimony Pendente LiteConfidential Information FormCOVID-19 Face Mask RequirementCriminal Division RulesCriminal Interpreter Request FormCriminal Record / Abuse History VerificationCriminal Scheduling FormCustody ComplaintCustody HandbookDivorce DecreeDivorce HandbookFamily Division RulesGuilt Plea ColloquyIn Forma Pauperis Petition - FormsIn Forma Pauperis Petition - InstructionsInterpreter Request Form - CivilInterpreter Request Form - CriminalInterpreter Request Form - FamilyInterpreter Request Form - MDJJuror Questionnaire - Civil CourtJuror Questionnaire - Criminal CourtJuror Service ReviewJury Summons QuestionnaireLanguage Access PlanLanguage Services ComplaintMotion for Appointment of MasterMunicipal Building Parking MapNew Local Rule 507Nolo Contendere PleaNotice of Intention to Request Decree under Section 3301(d)Notice of Proposed Relocation / Counter-Affidavit Regarding RelocationOrder of Appointment of ConciliatorOrphans' Court RulesParenting Plan FormParking MapPetition for ContemptPetition for ModificationPost Sentence ColloquyPraecipe to Transmit RecordRedistricting Plan for Lebanon County Magisterial District JudgesRule 600 Continuance FormSelf Represented Litigants HandbookService Document by Accepting ServiceService Document by Certified MailService Document by Personal ServiceService Form for Praecipe to Transmit RecordSpanish Form: Guilty Plea ColloquySpanish Form: Nolo Contendere PleaSpanish Form: Rule 600 ContinuanceSpanish Form: Waiver of ArraignmentSpanish Post Sentence Rights ColloquySpanish Waiver ArraignmentSpanish Waiver ArraignmentSpecialty Court ApplicationTranscript Request FormWaiver of Jury TrialWaivers of Notice of Intention to Request Decree Criminal Justice Advisory Board CJAB Letter for IP Grant 2016-2018IP Authorization Form 2021-2022Offender Reentry Plan District Attorney Precious Metals Unit Domestic Relations Policy for Submitting Medical Bills.pdfConfidential Information Form.pdfIN-005C - Complaint to Establish Paternity and for Genetic Testing -Non-IV-D.pdfAddress-Employer Change FormForm to Submit Medical Bills for CollectionInformation to Bring with You when Filing for SupportIntake QuestionnaireIntake Questionnaire (Spanish)Payment CouponPhysician's Information RequestPolicies & ProceduresPolicies & Procedures (Spanish)Policies for Submitting Medical Bills (Hidden) Emergency Management Agency Geographical Information Systems Lebanon County GIS Data Set Request Form Countywide.pdfLebanon County GIS Data Set Request Form by Municipality.pdf2008/2005 Color Imagery RequestBasic County MapContour Data RequestData DisclaimerDistribution PolicyE911 Addressing GuideLebanon County Scenic Bicycle Rides Human Resources MH/ID/EI Program Lebanon County - FY 21-22 Human Services PlanNo Wrong Door - 2021 Planning Department 2000 Census Fact Sheets by Municipality2010 Census Fact Sheets by MunicipalityApproved List of Pumper/HaulerBuilding Code InfoConstruction Code Permit ApplicationEvaluation of Solids/Scum in Treatment Tank FormFrequently Asked QuestionsGeneral Building Code InformationGeneral Sewage Enforcement InformationGeneral Sewage Management InformationHow to Qualify for an Exemption from the Current Pumping CycleLCPD Enforcement JurisdictionsLSCLW Strategic PlanMaintenance Agreement for Holding Tank FormMaintenance Agreement for Temporary Holding Tank FormOn-Lot Sewage Disposal System Complaint FormResidential Permit Fee WorksheetSewage Management Exemption Application FormSmall Municipal Separate Storm Sewer Systems (MS4s)State, County & Census Tract NumbersStorm Water Management Ordinance (40MB)Subdivision and Land Development Ordinance (36.2MB)Subdivision ProcedureUCC Permit ApplicationZoning Enforcement Program To find more Planning Department forms & documents, click on the following page links: Comprehensive Plan Metropolitan Planning Organization Prison System Inmate Handbook - EnglishInmate Handbook - SpanishMoney and Clothing Policy Probation Services Collections in the Courts.pdfAbility to Pay Evaluation - EnglishAbility to Pay Evaluation - SpanishAdult General Rules of SupervisionAdult Travel PassePay Brochure and User GuideJuvenile Community Service LogJuvenile General Rules of SupervisionLebanon County Probation Services Internship ProgramLicensed Substance Use Disorder Outpatient Treatment Providers Prothonotary's Office 236 NoticeArbitration AwardBoard of Assessment Appeal FormCivil Cover SheetFAMILY FEE - 2019 2020 2021Fee schedule - 2019 2020 2021MDJ AppealMotion to Release Escrowed FundsNotice of Appeal from Award of Board of ArbitratorsNotice of Election to Retake Prior Name: After Divorce ComplaintNotice of Election to Retake Prior Name: After Final DecreeOrder for Appointment of ConciliatorPetition and Order for Appointment of Special MasterPetition and Order for License or Registration Suspension AppealPetition and Order to Revoke and SubstitutePraecipe and Writ for PossessionPraecipe and Writ of Execution (w/ attachment): Money Judgment w/ NoticesPraecipe and Writ of Execution (w/o attachment): Money Judgment w/ NoticesPraecipe and Writ of Execution: Mortgage ForeclosurePraecipe and Writ of RevivalPraecipe and Writ of SummonsPraecipe and Writ to Join Additional DefendantsPraecipe for DispositionPraecipe for Entry of AppearancePraecipe for HearingPraecipe for JudgmentPraecipe for Motor Vehicle Judgment and CertificationPraecipe for Reference to Arbitrators and Waiver with OrderPraecipe to Settle, Discontinue, and SatisfyProthonotary Fee Schedule 2022Statement of Intention to ProceedSubpoena to Attend and TestifySubpoena to Produce Documents (Hidden) Public Defender Purchasing Department Request for Bids for Printing Services Recorder of Deeds FEE SCHEDULE FIRST PAGE 2017.pdfFee Schedule 2020.pdfE-Recording VendorsUPI Ordinance Register of Wills RegofWillsFeeSchedule2019.pdfMarriage Requirements.pdfRequisitos para Licencia de Matrimonio.pdfCovid Requirements FOR ML.pdf2014 Fee ScheduleOrphans' Court Rules (Hidden) Renova Center Sheriff's Office License To Carry Application.pdfBidding Information for Sheriff's SaleConditions of SaleLicense to Carry Firearms: InstructionsSheriff's Service Form (Hidden) Tax Claim Bureau Treasurer's Office Dog License: Lifetime FormDog License: Permanent ID Verification FormHotel Occupancy TaxHotel Tax: Monthly Tax Exemption FormHotel Tax: Registration FormHunting and Fishing LicensesReal Estate Tax Payment Instructions Veterans Affairs Burial Records A-BBurial Records C-EBurial Records F-GBurial Records H-JBurial Records K-LBurial Records Master List (51.5MB)Burial Records M-OBurial Records P-RBurial Records S-WBurial Records X-ZInterred Veterans for the CountyInterred: Annville TownshipInterred: Bethel TownshipInterred: City of LebanonInterred: Cornwall BoroughInterred: East Hanover TownshipInterred: Jackson TownshipInterred: Jonestown BoroughInterred: Millcreek TownshipInterred: Myerstown BoroughInterred: North Annville Township 1Interred: North Annville Township 2Interred: North Cornwall TownshipInterred: North Lebanon Township 1Interred: North Lebanon Township 2Interred: North Londonderry TownshipInterred: Palmyra BoroughInterred: Richland BoroughInterred: South Annville TownshipInterred: South Lebanon TownshipInterred: South Londonderry TownshipInterred: Swatara TownshipInterred: Union TownshipInterred: West Cornwall TownshipInterred:Heidelberg TownshipNumber of Interred by Municipality Voter Registration Office Voting System Demonstration.pdfVoter_Registration_Application_English.pdf2020 Important Dates_FINAL.pdfPADOS_MailInApplication.pdf2020 Primary General Election Public Notice 04-28-20.pdfVoter_Registration_Application_Spanish.pdf2021 Primary Municipal Election UMOVA NOTICE.docx2021 Primary Municipal Election UMOVA NOTICE.pdfCampaign Finance Report - Form 502 ($250 and over).pdfCampaign Finance Report - Form 502 ($250 and over).pdfCampaign Finance Report - Form 503 (Under $250).pdf2019 Municipal Election - Write In Votes2020 General Election Polling Locations2020 Polling Place Locations2020 Primary Election - Proposed Polling Place changes2020 Primary Election - Sample Ballots2020 Special Election - Paper Ballot2020 Special Election - Paper Ballot All Precincts2020 Special Election Public Notice2020 UMOVA Notice General Election 11-03-202020 UMOVA NOTICE Special Election 2021 Muncipal Primary - Candidate List2021 Municipal Election Candidate List2021 Municipal Election Sample Ballots2021 Municipal Election UMOVA NOTICE2021 Municipal Primary Candidate List2021 Municipal Primary Election - Casting of Lots2021 Municipal Primary Election Public Notice2021 Municipal Primary Sample Ballots2021 Polling Place Locations2021 Primary Packet - Running for Office2021 UMOVA NOTICE - MUNICIPAL PRIMARY ELECTIONAbsentee Ballot ApplicationAuthorized Designated Agent for Mail-In/Absentee BallotCandidate List - 2021 Municipal Primary Election Formulario de Inscripción del VotanteFrequently Asked Questions about Mail-In BallotsMail-In Perm Status Cancellation FormRepublican County Commitee Write-In WinnersRepublican County Committee - Casting of Lots for tiesVoter Registration FormVoting by Absentee or Mail-In Ballot (Hidden) Weights and Measures