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Once you have printed out your PRCUA search results and highlighted the name(s) of interest (see list of exceptions following), complete this form and mail it to the address below.

Please note that not all records are available:

  • Early records (1887-1912) were ledger records only.
  • Record numbers over 50200 are not accessible
  • Cash Surrender documents are not available.
  • Some documents were destroyed by basement flooding.

Include a check for a $10 (U.S.) donation (PGSA member) or $15 (U.S.) (non-member) per highlighted name. The donation is used for the costs of supplies, equipment, and materials. If you are not a member, please consider joining the Polish Genealogical Society of America, and taking immediate advantage of membership benefits.

Are you a PGSA Member? Yes____ No____ If yes, membership #_______

Amount submitted: $ ______ Please make check out to PGSA.

Email Address:_____________________________________

Name_______________________________________________________

Address _____________________________________________________

_________________________________________________________________

Please note that requests without the PRCUA search results will be returned.

Please send your order (this form, PRCUA search results, and check) with a Stamped Self-Addressed Envelope to:

Please send your request along with and a check or money order to:

PGSA - PRCUA Copy Requests
984 N. Milwaukee Ave.
Chicago, IL 60642-4101

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