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How to fill out the Pa 167 Form online
Filling out the Pa 167 Form online can streamline the process of designating your preferred language for communication with the Department of Public Social Services. This guide provides clear, step-by-step instructions for completing the form accurately and efficiently.
Follow the steps to complete the Pa 167 Form online.
- Click 'Get Form' button to obtain the form and open it in the editor.
- Begin by entering the case name in the designated field. This identifies your case within the system.
- Next, input the case number. This is essential for tracking your application effectively.
- In section A, indicate your spoken language preference by checking the appropriate box next to the language you prefer. This will ensure that you can communicate effectively with the staff regarding your case.
- If you have a preferred written language, proceed to section B. Indicate your choice by checking the corresponding box. You have the option to receive written communications in another language if available.
- In the signature area, provide your signature or mark to affirm that the language choices made are accurate. Date the form in the specified field to indicate when it was completed.
- Finally, ensure your case carrying worker's signature is included along with any necessary supervisor information. Save your changes, and proceed to download, print, or share the completed form as needed.
Complete your Pa 167 Form online today for efficient communication with your caseworker.
WRITING FROM THE DEPARTMENT, TO DISCLOSE ANY MONEY IN SALARY, WAGES, COMPENSATION, AND THE AMOUNTS AND DATES OF SUCH SALARY. THE DEPARTMENT CERTIFIES THAT THE EMPLOYEE BELOW IS APPLYING FOR, RECEIVING OR DID RECEIVE PUBLIC ASSISTANCE, OR IS A LEGALLY RESPONSIBLE RELATIVE OF THE EMPLOYEE.
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