Microsoft Word form - Uniontown Public Library

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Pennsylvania Room at Uniontown Public Library
Obituary Request
Thank you for your interest in the Pennsylvania Room! For best results, please read this form
carefully and fill it out as completely as you can.
Name:
Address:
Phone:
Email:
Obituary Look-Up
Provide at least the month and year of death and any common misspellings of the deceased’s
name. Max of 4 names per request.
Name:
Death Date:
Name:
Death Date:
Name:
Death Date:
Name:
Death Date:
Fee Table
The price per obituary is $5.00 plus 6% PA sales tax. Please make checks payable to the
Uniontown Public Library and note that this fee is retained regardless of request’s success.
1 obituary = $5.30
2 obituaries = $10.60
3 obituaries = 15.90
4 obituaries = $21.20
Method of Return
Please send hard copies in the enclosed self-addressed, stamped envelope.
Please send digital copies to the following email:
Please send your payment and request to the following address:
ATTN: PA ROOM
Uniontown Public Library
24 Jefferson Street
Uniontown, PA 15401
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