Below is a list of Certificate of Residency forms for

    Act 32 based on CLIU work locations.  

    •   Select your work location.
    •   Complete and print the form. Do not forget to sign it!
    •   For your home address, use your physical address.  NO PO Boxes.
    •   All sections in grey will be completed by HR-Payroll Office
    •   Forms can be sent via mail, email or fax to the HR-Payroll Office (610)769-1171

Allentown School District

Catasauqua Area School District

East Penn School District

Jim Thorpe Area School District

Lehighton Area School District

Northern Lehigh School District

Weatherly Area School District


Hospitals and Rehabilitation Networks