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Most Requested Forms:


NOTE:  In order to download these documents, your computer must be able to read PDF files.  If your computer cannot read PDF documents, or if you are not sure, the PDF reader may be downloaded here.


 

Privacy Act Form - Click here to download the Privacy Act Form pursuant to the terms of the Privacy Act of 1974 and the HIPAA Act of 2003, to authorize United States Representative Tim Holden, or any member of his staff he may designate, to receive any relevant information contained in any military, personnel, or other pertinent Federal agency records for the purpose of assisting you with your inquiry.


Birth Certificate - Click here to download an application to obtain a birth certificate from the Pennsylvania Department of Health, Vital Records.  Complete and print out this form and send it with a check or money order to my appropriate District Office for expedited service.  NOTE:  Fee does not apply to veterans or their dependents.


Request for military records - Click here to download the standard request form for military records from the U.S. National Archives and Records Administration.  Complete and print out this form and send it to my appropriate District Office for expedited service.


Application for a Social Security Card  - Click here to download an application for a new, duplicate, or corrected Social Security Card.  Complete and print out this form and return it to your local Social Security office.

 

Apply for a United States Passport - Click here to download an application for a United States Passport.

 

General Resources and Services:

 

Voter Guide   Fire Grant

 

 

 

   Official Seal

This is an official Web site of the 
United States House of Representatives

Washington Office

Congressman Tim Holden

2417 Rayburn HOB

Washington, D.C. 20515

(202) 225-5546

(202) 226-0996

Berks County Office
4918 Kutztown Road
Temple, PA 19560
Phone: (610) 921-3502
FAX: (610) 921-3504

Dauphin/Perry County Office
1721 North Front Street
Harrisburg, PA 17102
Phone: (717) 234-5904
FAX: (717) 234-5918

Lebanon County Office 
758 Cumberland Street
Lebanon, PA 17042
Phone: (717) 270-1395
FAX: (717) 270-1095

Schuylkill County Office
101 North Centre Street
Pottsville, PA 17901
Phone: (570) 622-4212
FAX: (570) 628-2561
 
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