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Instructions

Instructions
These are the instructions to fill out this request. You will need the following information before submitting this request: - Property Information - Owner Information - Corrective Action Request - Relevant request documentation.
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PROPERTY INFORMATION
Uniform Parcel Identifier (UPI)
If unsure of UPI, you can search here.
Property Viewer Map
Address of Property at Issue*
1. Check if more than one parcel is involved and that parcel is owned by a different owner.
Additional Property Information
Please include the UPI, owner's name, address, phone number and email.
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The undersigned hereby confirms that the information provided on and with the Request Form is true and correct to the best of his/her/their knowledge, information and belief. The undersigned understands that false statement herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities.
Electronic Signature Agreement*
By checking the "I agree" box below, you agree and acknowledge that 1) your form will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature of Owner(s)*
Electronic Signature of Applicant(s) (If different from Owner)
READY TO SUBMIT?
What Happens Next
Your CAP request shall be placed on the agenda for the next scheduled CAP request work session, which is held on the second Wednesday of every month (request forms and all supporting information must be submitted by the end of the current month to be placed on the following month’s agenda).

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