Jamestown, PA · Mercer County
Request for Names Form – Per Capita
Jamestown property owners use this form to provide information about people residing in a non-owner-occupied borough property for per capita purposes.
What this form is
This form requests the names, ages, and phone numbers of individuals residing at a non-owner-occupied Jamestown property for per capita purposes. It also asks for the property owner’s name and address, the property address, and the date. The document does not state when the city requires the form or provide submission instructions.
Who needs it
A property owner with a non-owner-occupied Jamestown property can use this form to list the individuals residing there for per capita purposes.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
No notary is required; the form asks for a date, and no notarized attachment or related sworn step is mentioned.
How to submit this form
- 1
Download The Form
Download the Jamestown Per Capita Names Request Form PDF.
- 2
Complete The Form
Enter the date, property owner’s name and address, and the address of the non-owner-occupied Jamestown property.
- 3
List The Residents
Provide the name, age, and phone number for each individual residing at the property.
- 4
Submit To The City
Submit the completed form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- What is the Jamestown Per Capita Names Request Form for?
- It collects the property owner’s name and address, the address of a non-owner-occupied Jamestown property, and the names, ages, and phone numbers of residents for per capita purposes.
- Who should complete this form?
- A property owner can use it to list individuals residing at a non-owner-occupied property in Jamestown.
- Do I need a notary for the Per Capita Names Request Form?
- No. The form asks for a date and does not mention a notarized attachment or related sworn step.
- How do I submit the Per Capita Names Request Form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.