Please read all instructions and then complete the following information and
Print, Sign, Date and Mail to:
Incorporated Village of Farmingdale
PO Box 220
361 Main Street
Farmingdale, NY 11735
(516) 249-0093
www.FarmingdaleVillage.org


CHANGE OF OWNERSHIP FOR WATER AND VILLAGE TAX BILLINGS

Please be advised that on (Date:)
ownership of premises at (Address:)
will be changed to (New Owners:)
Telephone No.:

Please direct all WATER BILLS to:
Name:
Address:

Please direct all VILLAGE TAX BILLS to:
Bank:
Mortgage No.:
Other:

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Signature Dated