This government document is issued by Education for use in Pennsylvania
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https://www.google.com/url?client=internal-element-cse&cx=007572080359491747877:kkqmv_r6zw4&q=https://www.education.pa.gov/Documents/Teachers-Administrators/Certifications/Fees%2520and%2520Forms/PDE%2520338%2520ES.pdf&sa=U&ved=2ahUKEwjw3ZOU1OGEAxUbKhAIHYyCAsA4HhAWegQIAhAB&usg=AOvVaw2GCJsj58UrfYVX_5VmHToN